Comparison of Acute In-vivo and Postmortem Ex-vivo MRI Metrics in Spinal Cord Injury

Motivation: Comparing MRI at time of spinal cord injury (SCI) with post-mortem ex-vivo imaging may help inform if, and how, acute-setting in-vivo clinical MRI can predict long-term tissue damage. Goal(s): To compare acute in-vivo MRI and postmortem ex-vivo MRI metrics in traumatic SCI. Approach: Comparisons between in-vivo MRI (lesion length, cord compression, canal compromise) and post-mortem MRI (lesion length, lesion volume, cord damage percentage) in 15 people were assessed using partial correlations and linear regressions. Results: In-vivo cord compression inversely correlated with injury-to-death interval. Ex-vivo lesion length and volume predicted percentage of core damage at epicenter. Acute and post-mortem MRI metrics were not related. Impact: Acute in-vivo MRI at time of spinal cord injury may be insufficient to predict the degree of permanent tissue damage. Additional MRI methods are needed to improve spinal cord injury long-term prognostication.