To Evaluate The Clinical Application Of DTI In Combination With SWI In Acute Spinal Cord Injury

Objective: Combined with SWI to investigate the value of DTIparameter changes and its relationship with nerve function in hemorrhagic andnon-hemorrhagic spinal cord injury, and observe the value of DTT image inshowing the severity of the spinal nerve damage.Methods: A total of15health controls and28patients with acute spinalcord injury within72h post-trauma underwent conventional MRI、SWI andDTI by using a3Tesla MRI system (Verio，siemens，Germany).The patientswere divided into spinal cord non-hemorrhagic group and hemorrhagic group,Spinal cord non-hemorrhagic group include normal spinal cord (group A) andspinal cord edema (group B), hemorrhagic group include spinal cord contusion(group C) and spinal cord hemorrhage (group D).All patients were assessedaccording to American Spinal Injury Association (ASIA). Analysis thecharacteristics of DTI and DTT image in the control group and the case group.The value of FA、ADC、λ1、λ2、λ3were measured in different vertebral levelof the control and in the injury level of the case group. Compared with thevalue of FA、ADC、λ1、λ2、λ3among the control group、the case group andits sub groups; Study the correlation at non-hemorrhagic group andhemorrhagic group between the value of DTI parameters and ASIA motorstores.Results: Conventional MRI and SWI showed that6cases had spinal cordnormal，10patients had spinal cord edema,7had contusion and5hadhemorrhage. FA maps showed inhomogeneous light blue signal mixed withlight green or red at the injured spinal cord, Gray scale ADC、λ2、λ3mapsexhibited inhomogeneous high intensity. DTT showed that the color of thefiber became into light blue or yellow in the no-hemorrhage group; however inthe hemorrhage group the fiber were not continuous, and broken end were red. In control group, all the values had no statistic difference at different vertebralsegment myeloid tissue. FA、ADC、λ2、λ3differed significantly between thehealthy controls and the patients(P<0.05), λ1has no significant differencebetween the health controls and the patients(P>0.05). All the DTI parametershad no significant difference between the health controls and A group(P>0.05);FA、ADC、λ2、λ3showed significant difference between the health controlsand B,C,D groups(P<0.05); λ1showed significant difference between thehealth controls and B, D groups(P<0.05). FA、λ2、λ3showed significantdifference in group A,B,C and D(P<0.05), From group A to group D, FAgradually decreased, λ2、λ3gradually increased; ADC showed no significantdifference between group B and group C(P>0.05); λ1showed no significantdifference between group A and C, between group B and D(P>0.05). Withinthe non-hemorrhagic group, strong correlations were observed between ASIAmotor scores and FA(r=0.78,P<0.05)、 ADC (r=-0.58,P<0.05)、 λ2(r=-0.66,P<0.05)、λ3(r=-0.80,P<0.05) at the injury site; However, nocorrelation was observed within the hemorrhagic group between any of theDTI parameters and ASIA motor scores（P>0.05）.Conclusion: The conventional MRI combined with SWI can better showthe spinal micro-hemorrhage.DTI is more sensitive than conventional MRI indetecting spinal cord injury. FA、λ2and λ3values can quantitatively analysisof the acute spinal cord injury, FA values are significant decreased, λ2and λ3values are significant increased. Strong correlations are observed within thenon-hemorrhagic group between ASIA motor scores and FA、ADC、λ2、λ3atthe injury site; However, no correlation is observed within the hemorrhagicgroup between any of the DTI parameters and ASIA motor scores.DTT candirectly noninvasive show the site and the severity of the spinal fiber damage.