Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Department of Bioengineering, Temple University, Philadelphia, Pennsylvania, USA.
J Spinal Cord Med. 2023 Nov;46(6):950-957. doi: 10.1080/10790268.2021.1997027. Epub 2021 Dec 2.
The purpose of this work was to employ a semi-automatic method for measuring spinal cord cross-sectional area (SCCSA) and investigate the correlations between diffusion tensor imaging (DTI) metrics and SCCSA for the cervical and thoracic spinal cord for typically developing pediatric subjects and pediatric subject with spinal cord injury.
Ten typically developing (TD) pediatric subjects and ten pediatric subjects with spinal cord injury (SCI) were imaged using a Siemens Verio 3 T MR scanner to acquire DTI and high-resolution anatomic scans covering the cervical and thoracic spinal cord (C1-T12). SCCSA was measured using a semi-automated edge detection algorithm for the entire spinal cord. DTI metrics were obtained from whole cord axial ROIs at each vertebral level. SCCSA measures were compared to DTI metrics by vertebral level throughout the entire cord, and above and below the injury site. Correlation analysis was performed to compare SCCSA, DTI and clinical measures as determined by the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) examination.
In subjects with SCI, FA and SCCSA had a positive correlation (r = 0.81, < 0.01), while RD and SCCSA had a negative correlation (r = -0.68, = 0.02) for the full spinal cord. FA and SCCSA were correlated above (r = 0.56, < 0.01) and below (r = 0.54, < 0.01) the injury site. TD subjects showed negative correlations between AD and SCCSA (r = -0.73, = 0.01) and RD and SCCSA (r = -0.79, < 0.01).
The ability to quickly and effectively measure SCCSA in subjects with SCI has the potential to allow for a better understanding of the progression of atrophy following a SCI. Correlations between cord cross section and DTI metrics by vertebral level suggest that imaging inferior and superior to lesion may yield useful information for diagnosis and prognosis.
本研究旨在采用半自动方法测量脊髓横截面积（SCCSA），并探讨扩散张量成像（DTI）指标与正常发育的儿科患者和脊髓损伤儿科患者的颈胸段脊髓 SCCSA 的相关性。
10 名正常发育的儿科患者（TD）和 10 名脊髓损伤的儿科患者（SCI）使用西门子 Verio 3T 磁共振扫描仪进行成像，以获取涵盖颈胸段脊髓（C1-T12）的 DTI 和高分辨率解剖扫描。使用半自动边缘检测算法对整个脊髓进行 SCCSA 测量。在每个椎体水平的整个脊髓轴向 ROI 中获得 DTI 指标。比较整个脊髓、损伤部位以上和以下各椎体水平的 SCCSA 测量值与 DTI 指标。通过国际脊髓损伤神经分类标准（ISNCSCI）检查，对 SCCSA、DTI 和临床指标进行相关性分析。
在 SCI 患者中，FA 和 SCCSA 之间呈正相关（r=0.81， < 0.01），而 RD 和 SCCSA 之间呈负相关（r=-0.68， = 0.02），全脊髓范围。FA 和 SCCSA 在损伤部位以上（r=0.56， < 0.01）和以下（r=0.54， < 0.01）均呈正相关。TD 患者的 AD 和 SCCSA（r=-0.73， = 0.01）以及 RD 和 SCCSA（r=-0.79， < 0.01）之间呈负相关。
在 SCI 患者中快速有效地测量 SCCSA 的能力有可能更好地了解 SCI 后萎缩的进展。按椎体水平测量脊髓横截面积和 DTI 指标之间的相关性表明，对病变上下进行成像可能会为诊断和预后提供有用的信息。
