Analysis of high-voltage electrical spinal cord injury using diffusion tensor imaging

Area of Science:

• Neuroimaging
• Neurology
• Radiology

Background:

• High-voltage electrical injuries frequently cause spinal cord injury (SCI), impacting neurological function.
• Understanding the precise pathological changes and location of SCI is crucial for patient management.
• Diffusion Tensor Imaging (DTI) offers a non-invasive method to assess white matter integrity.

Purpose of the Study:

• To investigate spinal cord injury (SCI) in high-voltage electrical injury patients using Diffusion Tensor Imaging (DTI).
• To compare DTI indices between patients and healthy controls across different spinal cord levels and locations.
• To correlate DTI findings with known pathophysiology of electrical SCI.

Main Methods:

• Eight high-voltage electrical injury patients and eight healthy controls underwent DTI and central motor conduction time assessments.
• DTI indices, including Fractional Anisotropy (FA), Mean Diffusivity (MD), Axial Diffusivity (AD), and Radial Diffusivity (RD), were measured.
• Analyses were performed at spinal cord levels C2-C7 and cross-sectionally (anterior, lateral, posterior).

Main Results:

• Patients exhibited significantly decreased FA and increased MD and RD values across all regions of interest (ROIs) compared to controls (p < 0.05).
• The anterior spinal cord ROIs showed a statistically significant decrease in FA compared to lateral and posterior regions in patients (p < 0.05).
• DTI indices did not significantly differ across spinal cord levels.

Conclusions:

• DTI effectively detects microstructural changes in the spinal cord following high-voltage electrical injury.
• Findings support the pathophysiology of myelinopathy and highlight the anterior spinal cord as a primary site of injury.
• DTI can corroborate and refine the understanding of electrical SCI, aiding in diagnosis and prognosis.