Evaluation of the Temporal Evolution of Acute Spinal Cord Injury

Runge, Val M.; Wells, John W.; Baldwin, Stanley A.; Blades, Deborah A.

doi:10.1097/00004424-199702000-00006

Cited by 27 publications

(30 citation statements)

References 20 publications

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“…It is interesting to compare our studies with those of Runge et al (13), who also reported in vivo, longitudinal contrast studies of experimental SCI. Our observation of changes in the lesion length with time is consistent with their results.…”

Section: Discussionmentioning

confidence: 56%

“…Our observation of changes in the lesion length with time is consistent with their results. As pointed out in the Introduction, Runge et al (13) reported postcontrast changes at a single time point following Gd administration. In contrast, we concentrated on the dynamic changes in contrast enhancement in order to follow the spatial-temporal evolution of injury for a longer period of time.…”

Section: Discussionmentioning

confidence: 94%

“…Angiogenesis was observed by Popovich et al (4) and Fraidakis et al (25) in the chronic phase of injury about 6 weeks after injury. Runge et al (13) performed their studies up to day 28, and apparently did not observe angiogenesis. In addition, unlike the studies in Ref.…”

Section: Discussionmentioning

confidence: 96%

“…In addition, unlike the studies in Ref. 13, we determined the contrast enhancement using an algorithm based on statistical signal detection theory to minimize potential operator bias. Such an approach combined with higher image resolution (0.1 mm in the current studies, as opposed to 0.4 mm in Ref.…”

Section: Discussionmentioning

confidence: 99%

“…In a most relevant work, Runge et al (13) performed longitudinal contrast-enhanced MRI studies on sagittal images of rodents at a single postcontrast time point on days 0, 7, 14, and 28. First, from a methodological point of view, our studies differ significantly from those of Runge et al in several important aspects, as discussed in the Discussion section.…”

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confidence: 99%

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Dynamic contrast‐enhanced MRI of experimental spinal cord injury: In vivo serial studies

Bilgen¹,

Abbe²,

Narayana³

2001

Magnetic Resonance in Med

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The progression of experimental spinal cord injury (SCI) was followed with in vivo dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and neurobehavioral studies on postinjury days 0, 2, 4, 7, 10, 14, 17, 21, 28, 35, and 42. Gadopentate dimeglumine (Gd) was administered IV and postcontrast, T 1 -weighted, axial images were acquired repetitively for up to 60 min. Images were analyzed to determine the spatial and temporal evolution of the intensity enhancement. A statistical decision mechanism was developed to objectively detect the enhancement. Strong and rapid enhancement was observed at the epicenter of injury, indicating a significant compromise in blood spinal cord barrier. The enhanced regions in each slice were combined to estimate the area and volume of the lesion. On the day of injury, around 85% of the total cord area at the epicenter showed enhancement within the first 15 min of Gd administration. At the same time, the enhanced volumes attained nearly 40% of the total cord volume and extended axially over 8 mm along the cord. The blood-spinal cord barrier (BSCB) maintains a highly regulated homeostatic environment in the spinal cord (SC) tissue. This regulatory function is sustained by various structures, including the capillary endothelial tight junctions. Under normal physiological conditions, BSCB protects the cord tissue by exhibiting selective permeability to the constituents of intravascular fluid (1,2). A traumatic insult to SC disrupts the structural and biochemical integrity of BSCB. The altered tight junctional patency allows vesicular transport of toxic substances from blood plasma to interstitial spaces. This makes the SC tissue environment unfavorable for neuronal survival, and inhibits tissue repair processes and neurologic recovery. By following the changes in BSCB after injury, important information may be gained about the regions of initial SC tissue damage and a time window for effective drug delivery across the barrier. Assessing BSCB in the late phases of the injury may help evaluate the progression of spinal cord injury (SCI) as well as the efficacy of potential therapeutic interventions.Changes in BSCB permeability can be followed experimentally using intravascularly administered tracers (such as plasma proteins, radiolabeled proteins, and small-molecular-weight molecules) that can cross the compromised barrier (3,4). Although these tracer-based techniques provide valuable information about the status of BSCB, they are either fully invasive, necessitating histological analysis of tissue, or less invasive but still requiring intravenous injection of radio-tracers with subsequent blood sampling along with imaging, as in the case of autoradiography. Moreover, active transport mechanisms involved in some of these tracers may introduce a bias in quantifying the BSCB permeability (4).As an alternative to the above techniques, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), with the exogenous paramagnetic contrast agent gadopentetate-dimeglumine (Gd, for short)...

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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