Correlation of MR Diffusion Tensor Imaging Parameters with ASIA Motor Scores in Hemorrhagic and Nonhemorrhagic Acute Spinal Cord Injury
Correlation of MR Diffusion Tensor Imaging Parameters with ASIA Motor Scores in Hemorrhagic and Nonhemorrhagic Acute Spinal Cord Injury
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DOI：
10.1089/neu.2010.1741
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发表时间：
2011-09-01
影响因子：
4.2
通讯作者：
Gullapalli, Rao P.
中科院分区：
文献类型：
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作者：
Cheran, Sendhil;Shanmuganathan, Kathirkamanathan;Gullapalli, Rao P.
本研究调查了创伤性颈髓损伤患者的美国脊髓损伤协会（ASIA）临床损伤运动评分与磁共振（MR）扩散张量成像（DTI）参数之间的相关性。对25例钝性脊髓损伤患者（年龄39.7 ± 13.9岁; 4例女性，21例男性）和11例志愿者（年龄31.5 ± 10.7岁; 3例女性，8例男性）进行常规成像和DTI评价。出血性（HC）13例，非出血性（NHC）12例。将脊髓分为三个区域，以解释DTI参数的空间和病理变化。区域和损伤部位的平均扩散率（MD），各向异性分数（FA），径向扩散率（λ（垂直））和纵向扩散率（λ（平行））与对照组进行了比较。ASIA运动评分与DTI相关性采用线性回归分析。HC和NHC患者在所有三个区域的MD和λ（平行于）均显示出显著降低（p < 0.001）。在损伤部位，两个损伤组的FA和λ（平行于）显著降低（p < 0.001）。λ（垂直于）值仅在NHC患者中显著增加（p < 0.05）。在损伤组（NH和NHC）和对照组之间，在整个脊髓水平观察到FA和λ（垂直）显著降低（p < 0.0001）。在NHC组内，观察到ASIA运动评分与损伤部位的平均MD、FA、lambda（垂直于）和lambda（平行于）之间存在强相关性。然而，在HC组内，任何DTI参数与ASIA运动评分之间均未观察到相关性。DTI参数反映了NHC患者脊髓损伤的严重程度，并与ASIA运动评分相关。
This study investigated correlations between American Spinal Injury Association (ASIA) clinical injury motor scores in patients with traumatic cervical cord injury and magnetic resonance (MR) diffusion tensor imaging (DTI) parameters. Conventional imaging and DTI were performed to evaluate 25 patients (age, 39.7 +/- 13.9 years; 4 women, 21 men) with blunt spinal cord injury and 11 volunteers (age, 31.5 +/- 10.7 years; 3 women, 8 men). Cord contusions were hemorrhagic (HC) in 13 and non-hemorrhagic (NHC) in 12 patients. The spinal cord was divided into three regions to account for spatial and pathological variation in DTI parameters. Comparisons of regional and injury site mean diffusivity (MD), fractional anisotropy (FA), radial diffusivity (lambda(perpendicular to)), and longitudinal diffusivity (lambda(parallel to)) were made with control subjects. ASIA motor scores were correlated with DTI using linear regression analysis. HC and NHC patients showed significant reduction (p < 0.001) in MD and lambda(parallel to) in all three regions. At the injury site, significant decreases in FA and lambda(parallel to) were seen for both injury groups (p < 0.001). lambda(perpendicular to) values were significantly increased only for patients with NHC (p < 0.05). Significant reduction in FA and lambda(perpendicular to) (p < 0.0001) was observed at the whole cord level between the injured (NH and NHC) and control groups. Within the NHC group, strong correlations were observed between ASIA motor scores and average MD, FA, lambda(perpendicular to), and lambda(parallel to) at the injury site. However, no correlation was observed within the HC group between any of the DTI parameters and ASIA motor scores. DTI parameters reflect the severity of spinal cord injury and correlate well with ASIA motor scores in patients with NHC.