Department of Radiology, University of Washington, Seattle, WA, USA.
Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
Br J Radiol. 2021 Feb 1;94(1118):20201000. doi: 10.1259/bjr.20201000. Epub 2020 Nov 18.
To evaluate segmented diffusion tensor imaging (DTI) white matter tract fractional anisotropy (FA) and mean diffusivity (MD) values in acute cervical spinal cord injury (CSCI).
15 patients with acute CSCI and 12 control subjects were prospectively recruited and underwent axial DTI as part of the spine trauma MRI. Datasets were put through a semi-automated probabilistic segmentation algorithm that analyzed white matter, motor and sensory tracts. FA and MD values were calculated for white matter, sensory (spinal lemniscal) and motor tracts (ventral/lateral corticospinal) at the level of clinical injury, levels remote from injury and in normal controls.
There were significant differences in FA between the level of injury and controls for total white matter (0.65 ± .09 0.68 ± .07; = .044), motor tracts (0.64 ± .07 0.7 ± .09; = .006), and combined motor/sensory tracts (0.63 ± .09 0.69 ± .08; = .022). In addition, there were significant FA differences between the level of injury and one level caudal to the injury for combined motor tracts (0.64 ± .07 0.69 ± .05; = .002) and combined motor/sensory tracts (0.63 ± .09 0.7 ± .07; = .011). There were no significant differences for MD between the level of injury and one level caudal to the injury or normal controls.
Abnormalities in DTI metrics of DTI-segmented white matter tracts were detected at the neurological level of injury relative to normal controls and levels remote from the injury site, confirming its value in CSCI assessment.
Segmented DTI analysis can help identify microstructural spinal cord abnormalities in the setting of traumatic cervical spinal cord injury.
评估急性颈脊髓损伤（CSCI）的分段弥散张量成像（DTI）白质束分数各向异性（FA）和平均弥散度（MD）值。
前瞻性招募了 15 例急性 CSCI 患者和 12 例对照者，并进行了作为脊柱创伤 MRI 一部分的轴向 DTI。数据集经过半自动概率分割算法处理，分析白质、运动和感觉束。在损伤水平、远离损伤水平和正常对照者处，计算白质、感觉（脊髓丘系）和运动束（腹侧/外侧皮质脊髓束）的 FA 和 MD 值。
在损伤水平与对照组之间，总白质（0.65±0.09 vs 0.68±0.07；=0.044）、运动束（0.64±0.07 vs 0.7±0.09；=0.006）和合并运动/感觉束（0.63±0.09 vs 0.69±0.08；=0.022）的 FA 存在显著差异。此外，在损伤水平与损伤下一水平之间，合并运动束（0.64±0.07 vs 0.69±0.05；=0.002）和合并运动/感觉束（0.63±0.09 vs 0.7±0.07；=0.011）的 FA 也存在显著差异。在损伤水平与损伤下一水平或正常对照组之间，MD 无显著差异。
与正常对照组和远离损伤部位的水平相比，在损伤的神经水平发现了 DTI 分段白质束的 DTI 指标异常，证实了其在 CSCI 评估中的价值。
分段 DTI 分析有助于在创伤性颈脊髓损伤的情况下识别脊髓的微观结构异常。
