Diffusion tensor imaging in spinal cord injury

Indian Journal of Radiology and Imaging, 2011 · DOI: 10.4103/0971-3026.85372 · Published: August 1, 2011

Spinal Cord Injury Neuroimaging Medical Imaging

Simple Explanation

Spinal cord injuries damage myelinated fibers, potentially leading to conditions like myelopathy. MRI can detect changes as increased signal intensity on T2W images. Diffusion tensor imaging (DTI) can detect abnormalities in the spinal cord, even when routine MRI results are normal. This study assesses DTI's ability to quantify Wallerian degeneration extent in spinal cord injuries, both in the cervical and dorsal cords.

Study Duration

3 months to 84 months

Participants

18 patients with spinal cord injury and 11 age-matched controls

Evidence Level

Not specified

Key Findings

1
The mean FA value was 0.550±0.09 in the control group and 0.367±0.14 in the patients; this difference was statistically significant (P=0.001).
2
Conventional T2W imaging did not show any signal changes in the cord above or below the lesion and at the same levels the FA values were obtained.
3
DTI can detect Wallerian degeneration, which is not detected on routine imaging.

Research Summary

This study investigates the feasibility of spinal tractography and fractional anisotropy (FA) value comparison in spinal cord injury patients versus a control group. DTI was performed on 29 subjects (18 patients, 11 controls), and FA values were calculated and compared, revealing a statistically significant difference (P=0.001). The study concludes that spinal tractography is feasible for assessing spinal cord injury extent via FA, which is reduced in patients, indicating Wallerian degeneration. This may be a useful tool for assessing cord injury patients after stem cell therapy.

Practical Implications

Assessment of Spinal Cord Injury Extent

Spinal tractography via DTI can effectively assess the extent of spinal cord injury by measuring fractional anisotropy (FA).

Detection of Wallerian Degeneration

DTI can detect Wallerian degeneration in spinal cord injuries, which may not be evident on routine MRI imaging.

Potential for Monitoring Stem Cell Therapy

DTI may serve as a tool to assess axonal regeneration in spinal cord injury patients undergoing stem cell therapy by tracking improvements in FA values.

Study Limitations

1
The study does not specify the severity or classification of spinal cord injuries.
2
The study involves a relatively small sample size.
3
The study does not include a longitudinal follow-up to assess long-term outcomes.

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