Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 100053, Beijing, China.
Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, 100053, Beijing, China.
Spinal Cord. 2024 Jul;62(7):414-420. doi: 10.1038/s41393-024-01000-w. Epub 2024 Jun 1.
Cross-sectional study.
To study the relationship between the structural changes in the cervical spinal cord (C2/3 level) and the sensorimotor function of children with traumatic thoracolumbar spinal cord injury (TLSCI) and to discover objective imaging biomarkers to evaluate its functional status.
Xuanwu Hospital, Capital Medical University, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, China.
30 children (age range 5-13 years) with TLSCI and 11 typically developing (TD) children (age range 6-12 years) were recruited in this study. Based on whether there is preserved motor function below the neurological level of injury (NLI), the children with TLSCI are divided into the AIS A/B group (motor complete) and the AIS C/D group (motor incomplete). A Siemens Verio 3.0 T MR scanner was used to acquire 3D high-resolution anatomic scans covering the head and upper cervical spinal cord. Morphologic parameters of the spinal cord at the C2/3 level, including cross-sectional area (CSA), anterior-posterior width (APW), and left-right width (LRW) were obtained using the spinal cord toolbox (SCT; https://www.nitrc.org/projects/sct ). Correlation analyses were performed to compare the morphologic spinal cord parameters and clinical scores determined by the International Standard for Neurological Classification of Spinal Cord Injuries (ISNCSCI) examination.
CSA and LRW in the AIS A/B group were significantly lower than those in the TD group and the AIS C/D group. LRW was the most sensitive imaging biomarker to differentiate the AIS A/B group from the AIS C/D group. Both CSA and APW were positively correlated with ISNCSCI sensory scores.
Quantitative measurement of the morphologic spinal cord parameters of the cervical spinal cord can be used as an objective imaging biomarker to evaluate the neurological function of children with TLSCI. Cervical spinal cord atrophy in children after TLSCI was correlated with clinical grading; CSA and APW can reflect sensory function. Meanwhile, LRW has the potential to be an objective imaging biomarker for evaluating motor function preservation.
横断面研究。
研究外伤性胸腰椎脊髓损伤（TLSCI）儿童颈椎脊髓（C2/3 水平）结构变化与感觉运动功能的关系，并发现客观的影像学生物标志物来评估其功能状态。
中国首都医科大学宣武医院；中国磁共振脑信息学北京市重点实验室。
本研究纳入了 30 名（年龄 5-13 岁）TLSCI 患儿和 11 名典型发育（TD）儿童（年龄 6-12 岁）。根据损伤神经水平以下是否有保留的运动功能，TLSCI 患儿分为 AIS A/B 组（运动完全）和 AIS C/D 组（运动不完全）。使用西门子 Verio 3.0T MR 扫描仪采集覆盖头部和上颈椎脊髓的 3D 高分辨率解剖扫描。使用脊髓工具箱（SCT；https://www.nitrc.org/projects/sct）获得 C2/3 水平脊髓的形态学参数，包括横截面积（CSA）、前后宽度（APW）和左右宽度（LRW）。通过国际脊髓损伤神经分类标准（ISNCSCI）检查，对形态学脊髓参数和临床评分进行相关性分析。
AIS A/B 组的 CSA 和 LRW 明显低于 TD 组和 AIS C/D 组。LRW 是区分 AIS A/B 组和 AIS C/D 组最敏感的影像学生物标志物。CSA 和 APW 均与 ISNCSCI 感觉评分呈正相关。
定量测量颈椎脊髓形态学脊髓参数可作为评估 TLSCI 患儿神经功能的客观影像学生物标志物。TLSCI 后儿童颈椎脊髓萎缩与临床分级相关；CSA 和 APW 可反映感觉功能。同时，LRW 有可能成为评估运动功能保留的客观影像学生物标志物。
