Evolution of Magnetic Resonance Imaging as Predictors and Correlates of Functional Outcome after Spinal Cord Contusion Injury in the Rat.
Evolution of Magnetic Resonance Imaging as Predictors and Correlates of Functional Outcome after Spinal Cord Contusion Injury in the Rat.
复制标题
磁共振成像作为大鼠脊髓挫伤后功能结果的预测因子和相关性的演变。
DOI：
10.1089/neu.2019.6731
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发表时间：
2020
影响因子：
4.2
通讯作者：
Budde,MatthewD
中科院分区：
文献类型：
--
作者：
Wilkins,Natasha;Skinner,NathanP;Motovylyak,Alice;Schmit,BrianD;Kurpad,Shekar;Budde,MatthewD
由于损伤的异质性和损伤的动态发展，临床上用于确定急性环境下创伤性脊髓损伤(SCI)严重程度和长期功能结果的方法在预测准确性方面受到限制。本研究的目的是评估先进的磁共振成像(MRI)方法对大鼠脊髓挫伤后神经功能的时程和敏感性。大鼠在T10使用减重装置进行分级挫伤。MRI包括损伤后1、30和90天的T2加权成像、定量T2成像和弥散加权成像(DWI)的形态测量。将所得指标与每周Basso、Beattie和Bresna han(BBB)运动评分和反射性排尿功能恢复评估的神经功能进行比较。在急性时间点(1dpi)，损伤中心对轴索损伤敏感的扩散指标与时间匹配的 评分相关性最强，预测90dpi的BBB评分最好。在30 dpi时，由弥散加权成像和T2值得出的轴突含水量均与时间匹配的运动评分相关。在慢性时间点(90 dpi)，横截面积与血脑屏障的相关性最密切。总体而言，结果显示，MRI指标在损伤后的不同时间点具有不同的敏感性，但这些指标遵循预期的急性轴索损伤病理，然后继续变性，最后是终末水平的萎缩。磁共振弥散加权成像在急性损伤中的特异性可能使其成为一种预测预后的工具，而T2成像在慢性损伤中提供了关于损伤严重程度的最多信息。
Clinical methods for determining the severity of traumatic spinal cord injury (SCI) and long-term functional outcome in the acute setting are limited in their prognostic accuracy because of the heterogeneity of injury and dynamic injury progression. The aim of this study was to evaluate the time course and sensitivity of advanced magnetic resonance imaging (MRI) methods to neurological function after SCI in a rat contusion model. Rats received a graded contusion injury at T10 using a weight-drop apparatus. MRI consisted of morphological measures from T2-weighted imaging, quantitative T2imaging, and diffusion-weighted imaging (DWI) at 1, 30, and 90 days post-injury (dpi). The derived metrics were compared with neurological function assessed using weekly Basso, Beattie, and Bresnahan (BBB) locomotor scoring and return of reflexive micturition function. At the acute time point (1 dpi), diffusion metrics sensitive to axonal injury at the injury epicenter had the strongest correlation with time-matched BBB scores and best predicted 90-dpi BBB scores. At 30 dpi, axonal water fraction derived from DWI and T2values were both correlated with time-matched locomotor scores. At the chronic time point (90 dpi), cross-sectional area was most closely correlated to BBB. Overall, the results demonstrate differential sensitivity of MRI metrics at different time points after injury, but the metrics follow the expected pathology of acute axonal injury followed by continued degeneration and finally a terminal level of atrophy. Specificity of DWI in the acute setting may make it impactful as a prognostic tool while T2imaging provided the most information about injury severity in chronic injury.