Measuring tract specific intramedullary damage level with 3D lesion segmentations following spinal cord injury

Motivation: Assessing the extent of intramedullary lesion after traumatic spinal cord injury (tSCI) has been shown to correlate with the severity of tSCI. We expand this approach, by understanding the injury's impact on individual spinal tracts and evaluating its connection to clinical severity. Goal(s): To fully characterize the extent of injury to the ascending and descending tracts on T2-weighted sagittal scans. Approach: We achieve this by manually delineating the lesion based on T2w-sagittal scans, projecting it into three planes, enabling 3D-visualization. Results: Significant correlations between damage to the left- and right-descending tracts, right-ascending tract and tract-associated clinical scores were found, indicating clinical validity. Impact: 3D-lesion characterization allows tract-specific analysis in traumatic SCI patients. It allows a precise assessment of injury to specific tracts on both sides of the spinal cord. This approach can inform tailored treatment and rehabilitation strategies.