Grassner Lukas, Leister Iris, Högel Florian, Sanktjohanser Ludwig, Vogel Matthias, Mach Orpheus, Maier Doris, Grillhösl Andreas
ParaMove, Spinal Cord Injury Research Unit, BG Trauma Center Murnau, Murnau, Germany.
Spinal Cord Injury Center, BG Trauma Center Murnau, Murnau, Germany.
J Neurotrauma. 2025 Feb;42(3-4):307-315. doi: 10.1089/neu.2023.0592. Epub 2024 Oct 25.
Magnetic resonance imaging (MRI) remains the gold standard for evaluating spinal cord tissue damage after spinal cord injury (SCI). Several MRI findings may have some prognostic potential, but their evolution over time, especially from the subacute to the chronic phase has not been studied extensively. We performed a prospective observational longitudinal study exploring the evolution of MRI parameters from the subacute to chronic phase after human traumatic cervical SCI. The study, conducted between 2016 and 2021, involved standardized neurological examinations and MRI scans 1 month, 3 months, and 1 year after SCI. The study cohort comprises 52 patients with cervical SCI. Patients were classified into AIS grades (American Spinal Injury Association Impairment Scale), and neurological recovery was assessed using the Integrated Neurological Change Score. The MRI protocol included various routine sequences, allowing the evaluation of established parameters such as intramedullary hemorrhage, lesion dimensions, maximum spinal cord compression, and various grading scales. The persistence of intramedullary hemorrhage one month after injury was associated with worse lower extremity motor scores and pinprick values after 3 months, and also in the chronic phase. In addition, dorsal column T2-weighted hyperintensities detected 3 months post-injury and in the chronic phase were related to lower pinprick sensory scores. The basic score and Sagittal Grade at 1 month were predictive for motor function 3 months after SCI and for neurological recovery between 1 and 3 months after injury. The study contributes valuable insights into the utility of routine MRI sequences for evaluating traumatic cervical SCI during the subacute to chronic phase. The identified MRI parameters and scores offer prognostic information and could support clinical decision-making.
磁共振成像（MRI）仍然是评估脊髓损伤（SCI）后脊髓组织损伤的金标准。几种MRI表现可能具有一定的预后潜力，但其随时间的演变，尤其是从亚急性期到慢性期的演变尚未得到广泛研究。我们进行了一项前瞻性观察性纵向研究，探讨人类创伤性颈髓损伤后从亚急性期到慢性期MRI参数的演变。该研究在2016年至2021年期间进行，包括在脊髓损伤后1个月、3个月和1年进行标准化神经学检查和MRI扫描。研究队列包括52例颈髓损伤患者。患者被分为AIS等级（美国脊髓损伤协会损伤量表），并使用综合神经变化评分评估神经恢复情况。MRI方案包括各种常规序列，可评估诸如髓内出血、病变大小、脊髓最大压迫以及各种分级量表等既定参数。损伤后1个月髓内出血的持续存在与3个月后以及慢性期更差的下肢运动评分和针刺觉值相关。此外，损伤后3个月及慢性期检测到的背柱T2加权高信号与更低的针刺觉感觉评分相关。1个月时的基础评分和矢状位分级可预测脊髓损伤后3个月的运动功能以及损伤后1至3个月的神经恢复情况。该研究为常规MRI序列在评估亚急性期至慢性期创伤性颈髓损伤中的应用提供了有价值的见解。所确定的MRI参数和评分提供了预后信息，并可支持临床决策。
