Applications of diffusion-weighted MRI in thoracic spinal cord injury without radiographic abnormality

Shen, Huiyong; Tang, Yong; Huang, Lin; Yang, Rui; Wu, Yanfeng; Wang, Peng; Shi, Yupeng; He, Xiaowen; Hu, Liu; Ye, Jichao

doi:10.1007/s00264-006-0175-y

Cited by 83 publications

(45 citation statements)

References 26 publications

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“…To date, there are few reports concerning the epidemiology of adult SCIWORA; unfortunately, the sample sizes were relatively small, and their results were almost inconclusive [18,25]. China is one of the largest countries in the world, and has a large population with increasing cervical degeneration [16].…”

Section: Introductionmentioning

confidence: 99%

Epidemiological characteristics of adult SCIWORA in Tianjin, China: a preliminary study

Guo

Liu

et al. 2011

Eur Spine J

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Introduction The epidemiology of spinal cord injury without radiographic abnormality (SCIWORA) is less frequently reported in adults as compared with children. ResultsIn total, 203 patients were enrolled. The average age among the adult groups was 55.9 years (men 55.8 years, women 53.6 years). SCIWORA occurred more commonly in adults in the 46-60 age group, and falls were the leading cause of injury (52.2%), followed by vehicular injury (28.6%). The most predominantly affected level was C4/5 (48.7%), followed by C5/6 (30.5%) and C3/4 (12.8%), respectively. The occurrence of central cord syndrome (50.2%) with posterior longitudinal ligament tear (43.8%) was relatively higher than other injury patterns. Conclusion It is clear that adult cervical SCIWORA is different from that in the pediatric group. Our study highlights the epidemiological properties of adult SCIW-ORA in Tianjin, China. Differing from other reports, particularly epidemiology study, we represent the first report regarding adult SCIWORA from China. As the geriatric population increases, it is very important to set up an individualized evaluation system based on a nationally scaled epidemiological database. The results from our study will be useful in assisting in the creation of such a database.

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Section: Introductionmentioning

confidence: 99%

Epidemiological characteristics of adult SCIWORA in Tianjin, China: a preliminary study

Guo

Liu

et al. 2011

Eur Spine J

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“…11 However, Shen et al, 12 who reported a patient with spinal cord injury who manifested no radiological abnormality, found that DWI but not T1-and T2-weighted MRI disclosed spinal cord signal changes.…”

Section: Discussionmentioning

confidence: 99%

Ultra-early MRI showing no abnormality in a fall victim presenting with tetraparesis

et al. 2007

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Case report: A patient presented to us with complete C4 tetraplegia after a 3-m fall. MRI performed 120 min after his fall showed spinal canal stenosis due to disk protrusion at the C3/4 level without spinal cord signal changes on T1-and T2-weighted images. He underwent laminoplasty between C2 and C6. Intraoperative ultrasound, performed 6 h after his fall, disclosed a hyperechoic lesion at the C3/4 level of the cervical cord; postoperative T2-weighted MRI, obtained at 8 h after his fall, showed high intensity at the same level. Conclusion: In patients with cerebral infarction, approximately 6 h between the insult and the acquisition of T2-weighted MRI are required to detect signal changes. We postulate that the time course on MRI scans obtained immediately after spinal cord injury is similar in patients with spinal cord injury and cerebral infarction and suggest that the absence of spinal cord abnormalities in the ultra-early post-injury stage is not always predictive of a good prognosis.

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“…Two studies were excluded, as one did not report the interval between injury and imaging and the other was not in English. 18,19 One study 20 and one case report 21 could be accepted for further analysis after accounting for the inclusion/exclusion criteria. In these reports, a total of 11 tSCI patients, who received conventional MRI and DW imaging within 24 h post-injury, were included ( Table 2).…”

Section: Medline Searchmentioning

confidence: 99%

Diffusion-weighted MR imaging within 24 h post-injury after traumatic spinal cord injury: a qualitative meta-analysis between T2-weighted imaging and diffusion-weighted MR imaging in 18 patients

et al. 2012

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Study design: Only few studies have been published about diffusion-weighted imaging (DWI) within 24 h of traumatic spinal cord injury (tSCI). Objectives: The purpose of this study was to compare the imaging findings from conventional magnetic resonance imaging (MRI) and DWI in seven tSCI patients with findings in the existing literature. Methods: Seven patients with tSCI at neurologic levels C2-T10 were examined with conventional MRI and DWI within 24 h postinjury. DWI was obtained with a b-factor of 1000 s mm -2 . American Spinal Injury Association (ASIA) scores and Spinal Cord Independence Measurement (SCIM) II item 12 after 12 months were collected. In addition, MEDLINE was searched from 1995 to 2010 to identify clinical tSCI studies reporting on MRI, DWI and apparent diffusion coefficient maps within 24 h post-injury to perform a meta-analysis. Images obtained with a b-factor of 1000 s mm -2 were compared with lower b-factors. Differences were calculated using w 2 tests. Results: No associations were identified between the images of the seven tSCI patients and ASIA or SCIM II scores. Eighteen SCI patients (11 from the retrieved publications) were included in the meta-analysis. The detection rates of hyperintense signals on T2-weighted and DW imaging did not show significant differences at 94 and 72%, respectively. In addition, there were no significant differences in detection rates or diffusion abnormalities between subjects in whom DW images were obtained with a maximum b-factor of 1000 or o1000 s mm -2 . Conclusion: Our analysis suggests that T2-weighted and DW imaging have comparable detection rates for spinal cord damage in tSCI patients within 24 h post-injury.

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Applications of diffusion-weighted MRI in thoracic spinal cord injury without radiographic abnormality

Cited by 83 publications

References 26 publications

Epidemiological characteristics of adult SCIWORA in Tianjin, China: a preliminary study

Epidemiological characteristics of adult SCIWORA in Tianjin, China: a preliminary study

Ultra-early MRI showing no abnormality in a fall victim presenting with tetraparesis

Diffusion-weighted MR imaging within 24 h post-injury after traumatic spinal cord injury: a qualitative meta-analysis between T2-weighted imaging and diffusion-weighted MR imaging in 18 patients

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