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Study design <p>Cross-sectional study.</p> Objectives <p>This study investigates changes in spinal DTI metrics above lesion in children with spinal cord injury without fracture or dislocation (SCIWOFD), aiming to assess DTI’s potential as a diagnostic and evaluative tool for SCIWOFD in children.</p> Setting <p>Xuanwu Hospital, Capital Medical University, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, China.</p> Methods <p>This study included 18 children with SCIWOFD and 12 typically developing (TD) children. SCIWOFD children underwent International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) assessments and MRI with axial spinal cord DTI. DTI data were processed with Diffusion Toolkit and TrackVis, with four levels above the lesion (Level 1 to Level 4). Spinal DTI metrics were extracted, and statistical analysis was performed using multiple linear regression and Pearson correlation.</p> Results <p>Compared to the TD group, the SCIWOFD group displayed significant changes in DTI metrics at four spinal cord levels. At level 1, FA decreased (<i>p</i> &lt; 0.000), while MD (<i>p</i> &lt; 0.000), AD (<i>p</i> = 0.007), and RD (<i>p</i> &lt; 0.000) increased. Levels 2 and 3 showed decreased FA (level 2: <i>p</i> &lt; 0.000; level 3: <i>p</i> = 0.001) and increased MD (level 2: <i>p</i> = 0.001; level 3: <i>p</i> = 0.029) and RD values (level 2: <i>p</i> &lt; 0.000; level 3:<i>p</i> = 0.001). At level 4, FA decreased (<i>p</i> &lt; 0.000), while RD increased (<i>p</i> = 0.009). At level 1 in the SCIWOFD group, MD (r = −0.534, <i>p</i> = 0.022) and RD (r = −0.569, <i>p</i> = 0.009) correlated with sensory scores.</p> Conclusions <p>Spinal DTI metrics above the lesion in children with SCIWOFD exhibit gradient changes, with a statistically correlation between the DTI metrics at the rostral edge of the lesion and ISNCSCI sensory scores. DTI metrics may serve as stable, objective indicators for assessing SCIWOFD in children.</p>

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Using diffusion tensor imaging to assess children with spinal cord injury without fracture or dislocation

  • 期刊论文

  • 发表日期：

    2025年5月31日

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  • Qunya Qi,
  • Ling Wang,
  • Beining Yang,
  • Yulong Jia,
  • Yu Wang,
  • Haotian Xin,
  • Xianglin Guo,
  • Weimin Zheng,
  • Xin Chen,
  • Qian Chen,
  • Fang Li,
  • Jubao Du,
  • Jie Lu,
  • Nan Chen

摘要

Study design

Cross-sectional study.

Objectives

This study investigates changes in spinal DTI metrics above lesion in children with spinal cord injury without fracture or dislocation (SCIWOFD), aiming to assess DTI’s potential as a diagnostic and evaluative tool for SCIWOFD in children.

Setting

Xuanwu Hospital, Capital Medical University, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, China.

Methods

This study included 18 children with SCIWOFD and 12 typically developing (TD) children. SCIWOFD children underwent International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) assessments and MRI with axial spinal cord DTI. DTI data were processed with Diffusion Toolkit and TrackVis, with four levels above the lesion (Level 1 to Level 4). Spinal DTI metrics were extracted, and statistical analysis was performed using multiple linear regression and Pearson correlation.

Results

Compared to the TD group, the SCIWOFD group displayed significant changes in DTI metrics at four spinal cord levels. At level 1, FA decreased (p < 0.000), while MD (p < 0.000), AD (p = 0.007), and RD (p < 0.000) increased. Levels 2 and 3 showed decreased FA (level 2: p < 0.000; level 3: p = 0.001) and increased MD (level 2: p = 0.001; level 3: p = 0.029) and RD values (level 2: p < 0.000; level 3:p = 0.001). At level 4, FA decreased (p < 0.000), while RD increased (p = 0.009). At level 1 in the SCIWOFD group, MD (r = −0.534, p = 0.022) and RD (r = −0.569, p = 0.009) correlated with sensory scores.

Conclusions

Spinal DTI metrics above the lesion in children with SCIWOFD exhibit gradient changes, with a statistically correlation between the DTI metrics at the rostral edge of the lesion and ISNCSCI sensory scores. DTI metrics may serve as stable, objective indicators for assessing SCIWOFD in children.