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Spinal Cord: Cross-sectional Anatomy01:16

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The cross-sectional anatomy of the spinal cord offers a detailed view of its complex structure and function within the central nervous system. At the core of the spinal cord lies the gray matter, characterized by its butterfly or "H"-shaped appearance in cross-section. This central region is enveloped by white matter, with the overall structure divided into symmetrical halves by the dorsal median sulcus and the ventral median fissure.
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Association of Spinal Cord Radiomic Features and Disability in Multiple Sclerosis.

Jeffrey Lambe1, Nicolas R Thompson2,3, Yadi Li2,3

  • 1Mellen Center for Multiple Sclerosis Treatment and Research, Neurology Department, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA.

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Radiomics analysis of spinal cord MRI reveals subtle pathology in multiple sclerosis (MS) patients, distinguishing disease subtypes and correlating with disability. This advanced imaging technique offers improved detection of neuroaxonal changes compared to conventional MRI.

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MRIdisabilitymultiple sclerosisradiomicsspinal cord

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Area of Science:

  • Neuroimaging
  • Radiology
  • Biomarkers

Background:

  • Spinal cord pathology is a key driver of disability in multiple sclerosis (MS).
  • Conventional MRI often fails to detect subtle spinal cord injuries in people with MS (pwMS).
  • Radiomics offers a novel approach to analyze image data for detecting imperceptible pathological changes.

Purpose of the Study:

  • To evaluate the utility of radiomics in spinal cord MRI for differentiating MS patient subgroups.
  • To assess the correlation between radiomic features and disability progression in pwMS.

Main Methods:

  • Radiomic features were extracted from T1-weighted MRI scans of the upper cervical cord in pwMS and healthy controls (HCs).
  • Neuroinflammation and neurodegeneration were assessed using U-Net convolutional neural networks on FLAIR and MPRAGE sequences.
  • Cervical cross-sectional area was measured, and imaging features were compared across groups and correlated with Patient-Determined Disease Steps (PDDS).

Main Results:

  • Radiomic features successfully distinguished pwMS from HCs and identified differences based on MS phenotype, age, and race.
  • Radiomic features demonstrated stronger correlations with PDDS than conventional MRI measures.
  • A total of 2966 pwMS and 41 HCs were included in the study.

Conclusions:

  • Radiomics can detect spinal cord pathologies in pwMS that are missed by conventional MRI.
  • This technique holds potential as a biomarker for predicting disability worsening in MS.
  • Radiomics may enhance the diagnostic yield of spinal cord MRI in the management of MS.