Using diffusion tensor imaging to assess children with spinal cord injury without fracture or dislocation

Area of Science:

• Neuroimaging
• Pediatric Neurology
• Spinal Cord Injury Research

Background:

• Spinal cord injury without fracture or dislocation (SCIWOFD) in children presents diagnostic challenges.
• Diffusion Tensor Imaging (DTI) offers insights into white matter microstructure.
• Assessing microstructural changes above the lesion is crucial for understanding SCIWOFD progression and recovery.

Purpose of the Study:

• To investigate changes in spinal DTI metrics in children with SCIWOFD.
• To evaluate the potential of DTI as a diagnostic and evaluative tool for pediatric SCIWOFD.
• To correlate DTI metrics with clinical neurological assessments.

Main Methods:

• Cross-sectional study involving 18 children with SCIWOFD and 12 typically developing (TD) children.
• Spinal DTI MRI was performed, analyzing metrics at four levels above the lesion.
• International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) assessments were conducted.

Main Results:

• Children with SCIWOFD showed significant alterations in DTI metrics (FA, MD, AD, RD) at all four levels compared to TD controls.
• Fractional Anisotropy (FA) decreased, while Mean Diffusivity (MD), Axial Diffusivity (AD), and Radial Diffusivity (RD) increased.
• DTI metrics at the first level above the lesion correlated with ISNCSCI sensory scores.

Conclusions:

• Spinal DTI metrics exhibit gradient changes above the lesion in pediatric SCIWOFD.
• DTI metrics demonstrate a statistically significant correlation with clinical sensory scores.
• DTI holds promise as a stable and objective tool for assessing SCIWOFD in children.