Clinical Application Of DTI For Cervical Spinal Cord Injury Without Radiographic Abnormality

Objective:To investigate the feasibility of clinical application and diagnostic value of MR diffusion tensor imaging (MR-DTI) in patients with cervical spinal cord injury without radiographic abnormality(CSCIWORA).Materials and Methods:GE1.5T superconductive MR scanner, Total of21patients with cervical SCIWORA and27healthy volunteers were selected prospectively. The scan sequences included conventional scans and DTI. The values of FA (Fractional Anisotropy) and ADC (Apparent Diffusion Coefficient) were measured by using Functool software.Results:the FA and ADC values of the healthy controls were0.645±0.016and (0.919±0.017)×10-3mm2/s respectively.Whereas, the FA and ADC values of patients with cervical SCIWORA were0.501±0.022and(1.008±0.287)×10-3mm2/s. Compared with the control group, the cervical SCIWORA cases had significantly lower FA values (P<0.05) and not significantly higher ADC values (P>0.05).Conclusions:DTI can sensitively detect the cervical SCIWORA which the conventional T2-weighted images failed to reveal.MR-DTI can provide more valuable information to evaluate the severity of cervical SCIWORA. Objeetive:To observe the correlation between features of diffusion tension imaging (DTI) and Japanese Orthopaedic Association (JOA) scores in patients with cervical spinal cord injury without radiographic abnormality (CSCIWORA).Materials and Methods:31CSCIWORA patients were assessed and divided into4stages. The score of stage Ⅰ/Ⅱ/Ⅲ/Ⅳ is16-13,12-9,8-5and less than4,respectively. All the patients accepted conventional scan and DTI, the Fractional Anisotropy (FA) and Apparent Diffusion Coefficient (ADC) were measured respectively, and the correlation to JOA scores was observed.Results:Stage Ⅰ:FA is0.569±0.044, ADC is1.035±0.060; Stage Ⅱ:FA is0.526±0.038, ADC is1.349±0.050; Stage Ⅲ:FA is0.494±0.020, ADC is1.020±0.078; Stage Ⅳ:FA is0.389±0.071, ADC is0.728±0.196. FA is related to JOA score of patients with CSCIWORA, ADC is not evidently related to JOA scores of patients with CSCIWORA.Conclusions:DTI could show the pathophysiology process more directly and more simply, and DTI can also sensitively detect the CSCIWORA which the conventional T2-weighted images failed to reveal. It is suggested that DTI can provide more valuable information to evaluate the severity of cervical spinal cord injury.