Segmented quantitative diffusion tensor imaging evaluation of acute traumatic cervical spinal cord injury

Area of Science:

• Neuroimaging
• Spinal Cord Injury Research
• Biomedical Engineering

Background:

• Acute cervical spinal cord injury (CSCI) involves complex white matter damage.
• Accurate assessment of microstructural changes is crucial for understanding CSCI.
• Diffusion tensor imaging (DTI) offers insights into white matter integrity.

Purpose of the Study:

• To evaluate fractional anisotropy (FA) and mean diffusivity (MD) values in segmented white matter tracts in acute CSCI.
• To determine the utility of DTI metrics in identifying spinal cord abnormalities post-injury.
• To compare DTI values between injured and control subjects.

Main Methods:

• Prospective recruitment of 15 acute CSCI patients and 12 controls.
• Axial DTI acquisition as part of spine trauma MRI.
• Semi-automated probabilistic segmentation for white matter, motor, and sensory tracts analysis.
• Calculation of FA and MD values at injury, remote, and control levels.

Main Results:

• Significant FA differences were observed between the injury level and controls for total white matter, motor tracts, and combined tracts.
• Significant FA differences were also found between the injury level and one level caudal for motor and combined tracts.
• No significant differences in mean diffusivity (MD) were detected between injury levels and controls.

Conclusions:

• DTI metrics reveal abnormalities in segmented white matter tracts at the neurological level of injury.
• These findings confirm the value of DTI in assessing CSCI.
• Segmented DTI analysis aids in identifying microstructural spinal cord abnormalities in traumatic CSCI.