Demyelination and degeneration in the injured human spinal cord detected with diffusion and magnetization transfer MRI
Demyelination and degeneration in the injured human spinal cord detected with diffusion and magnetization transfer MRI
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DOI：
10.1016/j.neuroimage.2010.11.089
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发表时间：
2011-04-01
期刊：
影响因子：
5.7
通讯作者：
Benali, H.
中科院分区：
文献类型：
--
作者：
Cohen-Adad, J.;El Mendili, M-M.;Benali, H.
外伤性脊髓损伤(SCI)患者脊髓通路脱髓鞘/变性的特征对于评估功能康复的预后至关重要。基于扩散加权(DW)磁共振成像(MRI)和磁化转移(MT)成像的新技术为脑白质病理提供了敏感和特异的标记物。在这篇论文中，我们首次结合高角分辨率扩散加权成像(HARDI)、MT成像和萎缩测量对14例SCI患者和年龄匹配的对照组的颈髓进行了评估。我们使用高平面分辨率来描绘背侧和腹外侧径路。在正常白质的分数各向异性(FA，p<；0.0001)、轴向扩散系数(p<；0.05)、径向扩散系数(p<；0.05)、广义分数各向异性(gFA，p<；0.0001)、磁化传递比(mtr，p<；0.0001)和脊髓面积(p<；0.05)方面，患者组与对照组之间存在显著差异。平均弥散系数(p=0.41)、T1加权(p=0.76)和12加权(p=0.09)信号无显著差异。MRI指标与临床残疾的相关性非常好(皮尔逊相关系数，FA：P<；0.01，GFA：P<；0.01，放射状弥散系数：P=0.01，MTR：P=0.04，萎缩：P<；0.01)。逐步线性回归分析显示，脊髓背侧MTR可预测感觉障碍，而脊髓腹外侧MTR可预测运动障碍(ASIA评分)。然而，弥散指标并不特定于感觉运动评分。由于轴向和径向弥散系数以及MT测量的特异性，结果提示在SCI患者中可以检测到脱髓鞘和变性。结合HARDI和MT成像是一种有希望的方法，以获得特异度，以确定脊髓路径的创伤。(C)2011 Elsevier Inc.保留所有权利。
Characterizing demyelination/degeneration of spinal pathways in traumatic spinal cord injured (SCI) patients is crucial for assessing the prognosis of functional rehabilitation. Novel techniques based on diffusion-weighted (DW) magnetic resonance imaging (MRI) and magnetization transfer (MT) imaging provide sensitive and specific markers of white matter pathology. In this paper we combined for the first time high angular resolution diffusion-weighted imaging (HARDI), MT imaging and atrophy measurements to evaluate the cervical spinal cord of fourteen SCI patients and age-matched controls. We used high in-plane resolution to delineate dorsal and ventrolateral pathways. Significant differences were detected between patients and controls in the normal-appearing white matter for fractional anisotropy (FA, p < 0.0001), axial diffusivity (p < 0.05), radial diffusivity (p < 0.05), generalized fractional anisotropy (GFA, p < 0.0001), magnetization transfer ratio (MTR, p < 0.0001) and cord area (p < 0.05). No significant difference was detected in mean diffusivity (p = 0.41), T1-weighted (p = 0.76) and 12-weighted (p = 0.09) signals. MRI metrics were remarkably well correlated with clinical disability (Pearson's correlations, FA: p < 0.01, GFA: p < 0.01, radial diffusivity: p = 0.01, MTR: p = 0.04 and atrophy: p < 0.01). Stepwise linear regressions showed that measures of MTR in the dorsal spinal cord predicted the sensory disability whereas measures of MTR in the ventrolateral spinal cord predicted the motor disability (ASIA score). However, diffusion metrics were not specific to the sensorimotor scores. Due to the specificity of axial and radial diffusivity and MT measurements, results suggest the detection of demyelination and degeneration in SCI patients. Combining HARDI with MT imaging is a promising approach to gain specificity in characterizing spinal cord pathways in traumatic injury. (C) 2011 Elsevier Inc. All rights reserved.