Diffusion Tensor Imaging at 3 Hours after Traumatic Spinal Cord Injury Predicts Long-Term Locomotor Recovery
Diffusion Tensor Imaging at 3 Hours after Traumatic Spinal Cord Injury Predicts Long-Term Locomotor Recovery
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DOI：
10.1089/neu.2009.1063
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发表时间：
2010-03-01
影响因子：
4.2
通讯作者：
Song, Sheng-Kwei
中科院分区：
文献类型：
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作者：
Kim, Joong H.;Loy, David N.;Song, Sheng-Kwei
在创伤后的早期阶段，必须对脊髓损伤（SCI）的严重程度进行准确的诊断，然后才能对高度积极的实验性治疗进行负责任的测试。这些研究首次表明，轴向扩散系数（λ平行），来自扩散张量成像（DTI）后3小时内SCI，准确预测长期的小鼠运动行为恢复。雌性C57 BL/6小鼠在T9椎骨水平进行假椎板切除术或分级挫伤性脊髓损伤（5组，每组n = 8）。SCI后立即进行活体DTI检查。使用Basso小鼠量表（BMS）获得后肢运动恢复的纵向测量值。在超急性期通过阈值分割可靠地分离了腹外侧白色物质（VLWM）的损伤区域和备用区域。在超急性期和损伤后14天，将平行于λ的测量值与组织学进行比较。通过平行于14天组织学的超急性λ测定的备用正常VLWM相关性良好（r = 0.95）。还观察到后肢运动功能恢复与λ平行于确定的备用正常VLWM之间的强相关性。在超急性期测量的正常VLWM每增加1%，显著运动恢复的几率增加18%（比值比= 1.18，p = 0.037）。测量脊髓生理学亚临床变化的能力和小鼠遗传优势为SCI的基本机制提供了一个早期窗口，这在以前是不可能的。尽管在人类患者中获得类似数据仍然必须克服重大障碍，但临床转化的道路是可以预见和实现的。
Accurate diagnosis of spinal cord injury (SCI) severity must be achieved before highly aggressive experimental therapies can be tested responsibly in the early phases after trauma. These studies demonstrate for the first time that axial diffusivity (lambda parallel to), derived from diffusion tensor imaging (DTI) within 3 h after SCI, accurately predicts long-term locomotor behavioral recovery in mice. Female C57BL/6 mice underwent sham laminectomy or graded contusive spinal cord injuries at the T9 vertebral level (5 groups, n - 8 for each group). In-vivo DTI examinations were performed immediately after SCI. Longitudinal measurements of hindlimb locomotor recovery were obtained using the Basso mouse scale (BMS). Injured and spared regions of ventrolateral white matter (VLWM) were reliably separated in the hyperacute phase by threshold segmentation. Measurements of lambda parallel to were compared with histology in the hyperacute phase and 14 days after injury. The spared normal VLWM determined by hyperacute lambda parallel to and 14-day histology correlated well (r = 0.95). A strong correlation between hindlimb locomotor function recovery and lambda parallel to-determined spared normal VLWM was also observed. The odds of significant locomotor recovery increased by 18% with each 1% increase in normal VLWM measured in the hyperacute phase (odds ratio = 1.18, p = 0.037). The capability of measuring subclinical changes in spinal cord physiology and murine genetic advantages offer an early window into the basic mechanisms of SCI that was not previously possible. Although significant obstacles must still be overcome to derive similar data in human patients, the path to clinical translation is foreseeable and achievable.