Clinical applications of MRI 3.0 T tractography in the spinal cord injury

Abstract

Introduction: Spinal cord lesions are often devastating. Clinical syndrome caused by a spinal injury includes paralysis of the limbs and trunk, with sensory disturbance and dysfunction of the gastrointestinal and genitourinary sphincters. Spinal lesions sometimes remain insufficiently visualized by conventional MRI, therefore it is an important region of interest in biomedical research. DTI (Diffusion Tensor Imaging) tractography is a quantitative MRI technique that can visualize the white matter tracts in vivo, so it can be useful in diagnosing spinal cord injury. Purpose and objectives: To assess the feasibility and clinical value of MRI 3.0 T tractography for evaluating spinal cord injury. Materials and Methods: Imaging was performed on total of 10 subjects: 7 patients with suspected pathology of the spine (ischemic, tumorous, degenerative) and 3 healthy volunteers. Imaging was performed at 3.0 T MRI (Siemens Skyra) with tractography reconstruction. Regions of interest were defined manually and measured on apparent diffusion coefficient (ADC) and fractional anisotropy (FA) maps. Results: In one patient with ependymoma tractography showed displacement of the fibers, one patient with traumatic spinal cord-interruption of the fibers, two patients with spinal com pression-local fiber tracts were compressed, 3 patients with ischemic lesions-insignificant interruption of fibers. In 3 volunteers the white matter tracts were normal. All patients had decreased FA values and increased ADC values at the affected spinal segments (which suggest fiber damage) and relatively normal FA values and ADC values cranial and caudal o f the lesion (which suggest that the lesion is much smaller that showed on the conventional MRI).