Development of an MRI Template & Neuroimaging Biomarkers of the Pediatric Spinal Cord

儿童脊髓损伤(SCI)的神经学后果尚不完全清楚。不能 准确评估儿科人群的运动、感觉和损伤程度引发了人们对 诊断、康复潜力和治疗效果。这项拟议的研究建立在该团队的 之前使用诸如扩散等先进成像方法建立定量成像生物标记物的工作 张量成像(DTI)、弥散峰度成像(DKI)和通过脊髓交叉评估的萎缩 截面积(Sccsa)-在儿童脊髓损伤患者中。近年来，磁共振成像(MRI) DTI、DKI、SCCSA测量和轴突定向密度弥散成像等方法 (NODI)已经显示出作为评估脊髓的有效和非侵入性生物标记物的有希望的结果 (Sc)在儿童中。据我们所知，到目前为止，我们的研究团队是唯一一个应用这些 向儿科人群提供成像技术。尽管所有这些技术都显示出了潜力 为了提供关于SC的微观结构信息，客观扩散的发展和应用-- 基于生物标记物的识别脊髓损伤的准确位置一直是具有挑战性的，因为 儿科SC的标准解剖模板和生物学年龄和性别匹配的标准值是 可用。因此，本研究的第一个目的是创建标准化的SC成像模板，并建立 对6-17岁的整个儿童SC进行SCCSA测量。这项研究的第二个目标是 颈胸段连续节段多层扩散成像正常值的建立 6-17岁的儿童SC。这项工作将导致标准化和一致的解释 这些神经成像指标将降低用户的可变性。这项工作的一个次要目标是演示 这些成像生物标志物在一组慢性运动完全性儿童中的可行性(美国脊柱) 损伤关联损伤量表(AIS)A和B)SCI。这项工作将通过以下方式解决一个重大的知识差距 为临床医生和研究人员提供功能成像生物标记物，以便他们能够客观地确定 儿童脊髓损伤的严重程度和程度，并建立预测模型。这项工作也将有助于 临床医生评估神经功能恢复，并在临床试验中评估治疗效果。此外, 这些成像生物标志物和标准模板可以推广到其他儿科SC疾病。 未来。

The neurological consequence of spinal cord injury (SCI) in children is not fully understood. The inability to accurately assess motor, sensation and extent of injury in the pediatric population raises speculation about diagnoses, recovery potential, and treatment effectiveness. This proposed study builds upon the team's previous work to establish quantitative imaging biomarkers using advanced imaging methods such as diffusion tensor imaging (DTI), diffusion kurtosis imaging (DKI) and atrophy estimated through a spinal cord cross sectional area (SCCSA) – in pediatric SCI patients. In the recent years magnetic resonance imaging (MRI) methods such as DTI, DKI, SCCSA measurements, and Neurite Orientation Density Dispersion Imaging (NODDI) have shown promising results as powerful and non-invasive biomarkers to evaluate the spinal cord (SC) in children. To the best of our knowledge, our research team is the only one thus far to apply these imaging techniques to the pediatric population. Although all of these techniques have demonstrated potential for providing microstructural information about the SC, the development and application of objective diffusion- based biomarkers for identifying the precise location of the injured cord has been challenging because neither a standard anatomical template of the pediatric SC nor biological age and sex matched normative values are available. Hence, the first aim of this study is to create a standardized SC imaging template and establish SCCSA measurements of the entire pediatric SC between 6-17 years of age. The second aim of this study will establish normative multishell diffusion imaging values for continuous segments of the cervical-thoracic pediatric SC between 6-17 years of age. This work will result in standardization and consistent interpretation of these neuroimaging metrics and will reduce user variability. A sub aim of this work is to demonstrate the feasibility of these imaging biomarkers in a group of children with chronic motor complete (American Spinal Injury Association Impairment Scale (AIS) A and B) SCI. This work will address a significant knowledge gap by providing functional imaging biomarkers to clinicians and researchers so they can objectively determine the extent of severity and level of injury and develop prediction models in pediatric SCI. This work would also aid clinicians in assessing neurological recovery, and evaluate treatment effectiveness in clinical trials. In addition, these imaging biomarkers and normative templates can be extended to other pediatric SC diseases in the future.