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Updated: Oct 16, 2025
Diffusion Imaging in the Rat Cervical Spinal Cord
Published on: April 7, 2015
Diffusional kurtosis imaging as a possible prognostic marker of cervical incomplete spinal cord injury outcome: a
Mathias Møller Thygesen1,2, Torben Ellegaard Lund3, Irene Klærke Mikkelsen4
1Department of Neurosurgery, Aarhus University Hospital, Palle Juul Jensens Blvd 99, 8200, Aarhus N, Denmark. matthy@rm.dk.
Background:
Spinal cord injury (SCI) is associated with substantial chronic morbidity and mortality. Routine imaging techniques such as T1- and T2-weighted magnetic resonance imaging (MRI) are not effective in predicting neurological deficiency grade or outcome. Diffusional kurtosis imaging (DKI) is an MR imaging technique that provides microstructural information about biological tissue. There are no longitudinal prospective studies assessing DKI metrics in acute traumatic SCI. Therefore, the purpose of this study was to establish a DKI protocol for acute SCI and correlate the DKI metrics to the functional neurological outcome of the patients.
Methods:
Eight consecutive SCI patients referred to our institution with cervical SCI were included in the study. An acute diagnostic MRI scan was supplemented with a novel fast, mean kurtosis DKI protocol, which describes the average deviation from Gaussian diffusional along nine different directions. Mean kurtosis values were measured at the injury site and normalized to the mean kurtosis values of a non-injured site. At discharge form specialized rehabilitation, patients were evaluated using the Spinal Cord Independence Measure-III (SCIM-III). The DKI metrics and SCIM-III were analysed using Spearman's rank correlation.
Results:
This pilot study found a significant correlation between decreasing mean kurtosis values at the injury site of the spinal cord and higher grade of disability measured by the SCIM-III (p = 0.002).
Conclusion:
This pilot study found that DKI may be a valuable tool as a prognostic marker in the acute phase of SCI.
Insights
Diffusional kurtosis imaging (DKI) shows promise for predicting outcomes after spinal cord injury (SCI). Lower DKI mean kurtosis values in the acute phase correlate with greater disability, suggesting its potential as an early prognostic marker.
Area of Science:
- Neuroimaging
- Radiology
- Spinal Cord Injury Research
Background:
- Spinal cord injury (SCI) leads to significant long-term health issues.
- Conventional MRI (T1/T2) is insufficient for predicting neurological deficits or outcomes post-SCI.
- Diffusional kurtosis imaging (DKI) offers microstructural tissue insights, but its use in acute SCI lacks longitudinal studies.
Purpose of the Study:
- To develop and validate a DKI protocol for acute traumatic SCI.
- To correlate DKI metrics with functional neurological outcomes in SCI patients.
Main Methods:
- Eight cervical SCI patients underwent acute MRI with a novel fast DKI protocol.
- Mean kurtosis values were measured at the injury site and normalized.
- Functional outcomes were assessed using the Spinal Cord Independence Measure-III (SCIM-III) at rehabilitation discharge.
- Spearman's rank correlation analyzed DKI metrics and SCIM-III scores.
Main Results:
- A significant inverse correlation was observed between DKI mean kurtosis values and SCIM-III disability scores (p = 0.002).
- Lower mean kurtosis at the injury site indicated a higher grade of disability.
Conclusions:
- DKI shows potential as a prognostic tool in the acute phase of SCI.
- This pilot study highlights DKI's ability to predict functional neurological outcomes.
