Application of diffusion tensor imaging in the prognosis of outcome after traumatic cervical spinal cord injury

Marcin Czyz, Tomasz Tykocki, Pawel Szewczyk, Wlodzimierz Jarmundowicz

Journal of Spinal Studies and Surgery 2017 1(2):25-28

Context: The Diffusion Tensor Imaging (DTI) is a modality of the MRI describing the integrity white matter tracts of the neural tissue by mean of fractional anisotropy (FA) and apparent diffusion coefficient (ADC). Aims: The aim of the study is to assess the usefulness of DTI in the acute assessment of patients after cervical tSCI. Settings and Design: Pilot prospective control-matched non-randomised experimental study. Materials and Methods: Five cervical tSCI patients were prospectively enrolled into the study. Neurological examination was followed by the MRI scan with DTI FA and ADC of the injured segments of the cervical spine. Obtained values were compared to the reference (healthy volunteers) by mean of statistical analysis. Statistical Analysis Used: SPSS 21.0 and MedCalc 12 software; non-parametric Spearman's rank correlation was used. The significance level was established as P < .05. Results: The FA correlated negatively with the ASIA motor score (-0.90, P = 0.037) and severity of neurological deficits (ASIA type A-E) (-0.95, P = 0.014). The ADC was positively correlated with ASIA motor score for upper limbs (0.86, P = 0.046). Two patients found with ADC higher than the reference presented early neurological recovery. Conclusions: DTI appears to be useful in the early assessment of tSCI. The FA reflects functional status of the spinal cord whilst ADC may serve a potential prognosticator.

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