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Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression

Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression

Published on: May 7, 2019

Quantified corticospinal tract diffusion restriction predicts neonatal stroke outcome.

Adam Kirton¹, Manohar Shroff, Tharshini Visvanathan

¹Children's Stroke Program, Division of Neurology, Hospital for Sick Children, Toronto, ON, Canada. adam.kirton@sickkids.ca

|February 3, 2007

Summary

Diffusion-weighted MRI signal changes in descending corticospinal tracts can predict motor deficits in infants after arterial ischemic stroke. This imaging technique offers a reliable tool for assessing outcomes in neonatal stroke patients.

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Determining the Functional Status of the Corticospinal Tract Within One Week of Stroke

Determining the Functional Status of the Corticospinal Tract Within One Week of Stroke

Published on: February 22, 2020

Area of Science:

Neuroimaging
Pediatric Neurology
Stroke Research

Background:

Neonatal arterial ischemic stroke affects over 1 in 4000 births.
Motor deficits are common in affected children, but acute outcome predictors are lacking.
Diffusion-weighted MRI (dMRI) changes in corticospinal tracts may indicate pre-Wallerian degeneration.

Purpose of the Study:

To verify and quantify dMRI signal changes in descending corticospinal tracts.
To correlate these signal changes with motor outcomes in neonates post-stroke.
To assess the utility of this imaging marker in predicting long-term motor function.

Main Methods:

Included 14 neonates with acute arterial ischemic stroke and >12 months follow-up.
Utilized the Pediatric Stroke Outcome Measure for outcome assessment.
Developed quantitative dMRI signal measurements of descending corticospinal tracts using Image J software.

Main Results:

Abnormal ipsilesional descending corticospinal tract dMRI signal found in 10 neonates (decreased ADC, P<0.001).
Poor motor outcome correlated significantly with percentage, length, and volume of affected descending corticospinal tracts.
Absence of dMRI signal abnormality predicted normal motor outcome; software analysis showed high reliability.

Conclusions:

Descending corticospinal tract dMRI signal is a predictive marker for motor outcomes in neonatal arterial ischemic stroke.
This accurate, reliable, and simple imaging tool can aid acute neonatal stroke management.
Early identification of prognosis through dMRI can inform clinical decision-making and interventions.