Magnetic resonance diffusion tensor imaging of acute spinal cord injury in spinal trauma

Abstract

Background It was important to develop a non-invasive imaging technique for early evaluation of spinal cord integrity after injury; MRI was the method of choice for evaluation of any cord abnormalities. However, some patients have symptoms with no detectable abnormalities by MRI. The purpose of our study was to assess the role of diffusion tensor MRI in evaluating the integrity of spinal cord fibers in case of spinal trauma. Results Out of the studied 30 patients, conventional MRI revealed abnormalities in the spinal cord in 23 patients (76.67%), diffusion tensor tractography revealed abnormalities in the spinal cord in 27 patients (90%), the mean FA value at the level of injury (0.326±0.135) was less than the mean FA value (0.532 ± 0.074) in control group (p value < 0.001), and the mean ADC value at the level of injury (1.319 ± 0.378) was less than the mean ADC value (1.734 ± 0.768) in the control group. FA was sensitive than ADC in the detection of the spinal cord abnormalities with a sensitivity of 93.33% versus 67.66% respectively. Conclusion DTI can be used to detect structural changes of spinal cord white matter fibers in acute spinal cord injury. A significant decrease of fractional anisotropy and apparent diffusion coefficient has been found at the site of spinal cord injury.

Functional recovery of a 41-year-old quadriplegic spinal cord injury patient following multiple intravenous infusions of autologous adipose-derived mesenchymal stem cells: a case report

“…However, at least another study using intrathecal administration of autologous adMSCs showed no interval change in lesion site between baseline and at the 8-month follow-up MRI, post-treatment ( 13 ). Moreover, while MRI has become a conventional imaging technique for spinal cord injuries, it has been suggested that its usage may be limited because of the non-specificity of changes in signal intensity that do not directly reflect physiological changes ( 29 ). Additionally, there is evidence that MRIs are more effective when used acutely following a spinal cord injury, specifically within the first 72 h, for prognostication, as opposed to being used for management over lengthy durations of time, as was done in this study ( 30 ).…”

Diffusion Tensor Imaging in Spinal Cord Injury: A Review

“…28 Another application of DTI is diffusion tensor tractography, which enables three-dimensional demonstration of the white matter fibers (axons). 1…”