The influence of conventional T2 MRI indices in predicting who will walk outside one year after spinal cord injury
The influence of conventional T2 MRI indices in predicting who will walk outside one year after spinal cord injury
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DOI：
10.1080/10790268.2021.1907676
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发表时间：
2021-04-03
影响因子：
1.7
通讯作者：
Smith, Andrew C.
中科院分区：
文献类型：
--
作者：
Berliner, Jeffrey C.;O'Dell, Denise R.;Smith, Andrew C.
背景/目的脊髓损伤的磁共振成像 (MRI) 指数可预测脊髓损伤 (SCI) 后的未来运动功能：高信号长度、正中矢状组织桥以及脑和脊髓损伤中心 (BASIC) 评分。这些指数是否可以预测 SCI 后的户外行走尚不清楚。主要目的是看看这些 MRI 指数是否可以预测 SCI 后一年的户外行走能力。第二个目的是确定如果初始下肢运动评分可用，MRI 指数是否提供额外的预测价值。设计回顾。临床 T-2 加权 MRI 用于量化脊髓损伤。计算三个MRI指标：正中矢状腹侧组织桥、高信号长度、BASIC评分。设置院校医院。参与者129名颈椎SCI参与者。干预措施住院康复。结果测量SCI后一年，参与者自我报告其户外行走能力。结果中矢状腹侧组织桥、高信号长度和BASIC得分与户外行走能力显着相关（R = 0.34，P < 0.001；Rs = -0.25，P < 0.01；Rs = -0.35，P < 001）。使用正中矢状腹侧组织桥和高信号长度，模型 1 的最终调整 R (2) = 0.19。对于模型 2，仅使用运动评分调整后的 R (2) = 0.81，MRI 变量不显着。所有五名可观察到髓内出血的参与者均报告称，他们无法在户外行走一个街区。 结论 MRI 指数是户外行走能力的重要预测因子，但当运动评分可用时，这是最强的预测因子，正中矢状组织桥和高信号长度都没有贡献额外的价值。当无法进行运动测试时，MRI 指数可能是体格检查的快速便捷的补充。
Context/ObjectiveMagnetic resonance imaging (MRI) indices of spinal cord damage are predictive of future motor function after spinal cord injury (SCI): hyperintensity length, midsagittal tissue bridges, and Brain and Spinal Injury Center (BASIC) scores. Whether these indices are predictive of outdoor walking after SCI is unknown. The primary purpose was to see if these MRI indices predict the ability to walk outdoors one-year after SCI. The secondary purpose was to determine if MRI indices provide additional predictive value if initial lower extremity motor scores are available.DesignRetrospective. Clinical T-2-weighted MRIs were used to quantify spinal cord damage. Three MRI indices were calculated: midsagittal ventral tissue bridges, hyperintensity length, BASIC scores.SettingAcademic hospital.Participants129 participants with cervical SCI.InterventionsInpatient rehabilitation.Outcomes MeasuresOne year after SCI, participants self-reported their outdoor walking ability.ResultsMidsagittal ventral tissue bridges, hyperintensity length, and BASIC scores significantly correlated with outdoor walking ability (R = 0.34, P < 0.001; R = -0.25, P < 0.01; Rs = -0.35, P < 001, respectively). Using midsagittal ventral tissue bridges and hyperintensity length, the final adjusted R (2) for model 1 = 0.19. For model 2, the adjusted R (2) using motor scores alone = 0.81 and MRI variables were non-significant. All five participants with observable intramedullary hemorrhage reported they were unable to walk one block outdoors.ConclusionsThe MRI indices were significant predictors of outdoor walking ability, but when motor scores were available, this was the strongest predictor and neither midsagittal tissue bridges nor hyperintensity length contributed additional value. MRI indices may be a quick and convenient supplement to physical examination when motor testing is unavailable.