Prognosis of cervical spinal cord injury in correlation with magnetic resonance imaging

Sato, Tatsuya; Kokubun, S.; Rijal, K P; Ojima, Toshiyasu; Moriai, Norio; Hashimoto, Makiko; Hyodo, Hironori; Oonuma, H

doi:10.1038/sc.1994.14

Cited by 21 publications

(9 citation statements)

References 8 publications

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“…6,7,12,13 Its presence has been reported to suggest a poor prognosis for neurological recovery. 4,14,15 In our patients, nine of the ten patients exhibiting this low signal change had grade A paralysis from onset to 1 year after injury ( Figure 5: pattern 4). Two of these patients complained of increasing pain and numbness in the arms and ®ngers, and showed a reduction in diaphragmatic movement at 3 weeks after injury.…”

Section: Discussionmentioning

confidence: 60%

Sequential MR studies of cervical cord injury: correlation with neurological damage and clinical outcome

Shimada

Tokioka

1999

Spinal Cord

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In patients with acute traumatic cervical spinal cord injury, it is di cult to make a precise diagnosis of the main site of the injury, the severity of cord damage, and the prognosis of neurological complications Objective: To determine which images provide the most useful information and the best time to perform prognostic MRI. Design: The severity of neurological complications was assessed using the ASIA impairment scale. MRI was ®rst performed within 48 h of injury, and was subsequently performed after 2 ± 3 weeks, 3 months, 6 months, and 1 year. Setting: Inpatient SCI medicine unit. Subjects: Seventy-®ve patients with acute traumatic cervical spinal cord injury (9 women and 66 men) aged from 19 ± 89 years (mean: 54.7 years). Results: Four characteristic patterns of signal changes were observed on MRI. These patterns correlated well with the severity of spinal cord damage and the clinical outcome. Conclusion: T2-weighted images provided the most useful information, and the best times for prognostic imaging were at the time of injury and 2 ± 3 weeks later.

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Section: Discussionmentioning

confidence: 60%

Sequential MR studies of cervical cord injury: correlation with neurological damage and clinical outcome

Shimada

Tokioka

1999

Spinal Cord

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“…Most studies showed that patients with spinal cord hemorrhage will have decreased motor power, lower motor recovery rates, and fewer muscles with useful function, 1 year after injury in comparison with subjects with small, non-hemorrhagic lesions (Bondurant et al, 1990; Flanders et al, 1990, 1996; Yamashita et al, 1991; Schaefer et al, 1992; Marciello et al, 1993; Sato et al, 1994; Ramón et al, 1997); hemorrhage on initial MRI (within 15 days from the lesion) is associated with a complete injury in almost 100% of the patients (Ramón et al, 1997). If no hemorrhage is seen on initial MRI, patients will have an incomplete lesion and have a significantly better prognosis for motor recovery in the upper and lower extremities, as well as improvement in their Frankel and/or ASIA impairment scale classification (Schaefer et al, 1992).…”

Section: Instrumental Examinationmentioning

confidence: 99%

Who is going to walk? A review of the factors influencing walking recovery after spinal cord injury

Scivoletto

Tamburella

Laurenza

et al. 2014

Front. Hum. Neurosci.

138

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The recovery of walking function is considered of extreme relevance both by patients and physicians. Consequently, in the recent years, recovery of locomotion become a major objective of new pharmacological and rehabilitative interventions. In the last decade, several pharmacological treatment and rehabilitative approaches have been initiated to enhance locomotion capacity of SCI patients. Basic science advances in regeneration of the central nervous system hold promise of further neurological and functional recovery to be studied in clinical trials. Therefore, a precise knowledge of the natural course of walking recovery after SCI and of the factors affecting the prognosis for recovery has become mandatory. In the present work we reviewed the prognostic factors for walking recovery, with particular attention paid to the clinical ones (neurological examination at admission, age, etiology gender, time course of recovery). The prognostic value of some instrumental examinations has also been reviewed. Based on these factors we suggest that a reliable prognosis for walking recovery is possible. Instrumental examinations, in particular evoked potentials could be useful to improve the prognosis.

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“…In manual lesion volume estimation, for each mm 3 increase in the mean, the difference decreased by − 0.82 mm 3 (95% CI, − 1.07 to − 0.58 mm 3 ). In the semiautomated lesion volume estimation, for each mm 3 increase in the mean, the difference decreased by − 0.65 mm 3 (95% CI, − 0.78 to − 0.51 mm 3 (Figures 6 and 7). There was no significant linear association between the difference and the mean of the techniques (Evaluator 1: P = 0.0816 and Evaluator 2: P = 0.0697).…”

Section: Agreement: Volume Estimationmentioning

confidence: 99%

“…1 Magnetic resonance imaging (MRI) has been used in humans to diagnose SCI for three decades and has been proposed as a viable in vivo biomarker. [2][3][4] High T2 signal intensity within the spinal cord following injury is correlated with identifiable edema, necrosis, cellular infiltrates and hemorrhage. 5,6 The presence of such lesions has been associated with slowed recovery across a number of model systems and in humans.…”

Section: Introductionmentioning

confidence: 99%

Quantitative magnetic resonance imaging in a naturally occurring canine model of spinal cord injury

Griffin

Davis

et al. 2015

Spinal Cord

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Study design: Retrospective cohort study. Objectives: To analyze magnetic resonance imaging (MRI) evaluator agreement in dogs with spinal cord injury (SCI) caused by intervertebral disk herniation (IVDH) using semiautomated and manual lesion segmentation and to analyze the associations between MRI and functional outcome. Setting: United States of America. Methods: T2-weighted MRIs from dogs with SCI resulting from thoracolumbar IVDH were identified from a database. Evaluators categorized MRIs on the basis of the presence or absence of a T2-hyperintense spinal cord lesion in axial and sagittal images. A semiautomated segmentation algorithm was developed and used to estimate the lesion volume. Agreement between evaluators and between semiautomated and manual segmentation was analyzed. The relationships of qualitative and quantitative MRIs with behavioral functional outcome were analyzed. Results: Axial images more commonly depicted lesions compared with sagittal images. Lesions in axial images had more consistent associations with functional outcome compared with sagittal images. There was imperfect qualitative agreement, and lesion volume estimation was imprecise. However, there was improved precision using semiautomated segmentation compared with manual segmentation. Conclusion: Lesion volume estimation in dogs with naturally occurring SCI caused by IVDH is challenging, and axial images have important advantages compared with sagittal images. The semiautomated segmentation algorithm described herein shows promise but may require further refinement. INTRODUCTIONSpinal cord injury (SCI) is a devastating disease process that results in disability, loss of quality of life and cost to the health-care system. Currently, there are no therapies that robustly improve functional outcomes. 1 Magnetic resonance imaging (MRI) has been used in humans to diagnose SCI for three decades and has been proposed as a viable in vivo biomarker. 2-4 High T2 signal intensity within the spinal cord following injury is correlated with identifiable edema, necrosis, cellular infiltrates and hemorrhage. 5,6 The presence of such lesions has been associated with slowed recovery across a number of model systems and in humans. 2,7,8 More recently, spinal cord lesion volume as measured by MRI has been used to quantitatively characterize SCI following clinical interventions. 9 Canine intervertebral disk herniation (IVDH) is a common, naturally occurring SCI that is seen in pet dogs. 10,11 Canine IVDH shares many features with human SCI including lesion histopathology, presence of compressive/contusive facets of injury and use of surgical/ rehabilitative treatment modalities. 10,11 As is the case in humans, data from dogs with IVDH suggest that T2-hyperintense lesions within the spinal cord are correlated with behaviorally severe injuries and poorer long-term motor recovery. 11

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Prognosis of cervical spinal cord injury in correlation with magnetic resonance imaging

Cited by 21 publications

References 8 publications

Sequential MR studies of cervical cord injury: correlation with neurological damage and clinical outcome

Sequential MR studies of cervical cord injury: correlation with neurological damage and clinical outcome

Who is going to walk? A review of the factors influencing walking recovery after spinal cord injury

Quantitative magnetic resonance imaging in a naturally occurring canine model of spinal cord injury

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