Diffusion tensor imaging in the study of spinal tract degeneration after spinal cord injury: a prospective study

INTRODUCTION : Spinal cord injuries in children account for up to 10% of all injuries in children, but remain a significant problem, as they often lead to serious consequences, including disability. Traditional MRI does not allow detecting differences in undamaged parts of the spinal cord in either the acute or chronic period. Introduction of diffusion tensor imaging (DTI) into the protocol for examining damaged spinal cord allows detecting even minimal but significant microstructural abnormalities. OBJECTIVE : Тo evaluate, using DTI, microstructural changes in the ascending and descending fibers of the cervical spinal cord above the level of injury in patients with spinal cord trauma at different periods after injury. MATERIALS AND METHODS : The study included 39 children aged 12 to 18 years (mean age 14.3±1.8 years) with spinal cord injury below the level of the Th3 vertebra, including: 21 patients with complete spinal cord injury — grade A according to the ASIA classification (group A), 18 patients with incomplete spinal cord injury — grade B-D according to the ASIA classification (group B). The study was performed on an MRI scanner 3.0 T Philips Achieva dStream. The following DTI parameters were taken into account: FA, AD, MD, RD. RESULTS : In the area of lateral corticospinal tract, a decrease in FA value and an increase in RD value for patients of group A compared to the control group during the recovery period were revealed. In the area of the dorsal funiculi, a decrease in FA values for patients of group A is observed already in the subacute period after injury. CONCLUSION : DTI is a convenient tool for analyzing the post-traumatic spinal cord, since it allows not only to detect changes that are not visible with other research methods, but also to obtain quantitative characteristics, which allows on their basis to form objective criteria for assessing state of spinal cord, which can then be used to monitor the treatment and rehabilitation of children with spinal cord injury.