DTI对急性颈髓损伤ASIA不同残损等级的研究

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Abstract Objective: To study the clinical value of DTI in acute spinal cord injury(SCI) with different ASIA grades. Methods: A retrospective analysis of 34 acute SCI patients with conventional MRI T2WI hyperintensity was made. All patients underwent MR-DTI examination in 48 hours. According to ASIA grades, we measured the values of FA, ADC, λ∥, λ⊥in the injury area. We recruited 15 healthy volunteers of matched ages, and measured the same parameters in the corresponding level of C3/4~C5/6 intervertebral disc plane. Single factor analysis of variance(ANOVA) was applied to analyze the difference in DTI parameters in ASIA grade A to D. Independent sample t test was used to analyze DTI parameters in DWI image matching area(hyperintense on both DWI and T2WI) and mismatch area(isointense on DWI but hyperintense on T2WI) in the same patients. Results: The number of patients is 7 in grade A, 5 in grade B, 19 in grade C, and 13 in grade D. Compared with the healthy group, the A～D groups showed significant differences in FA, ADC, λ∥ and λ⊥(F=51.90, 13.30, 24.70, 13.01, P<0.001). Compared with grade B, C and D, the values of FA, ADC and λ∥ in grade A were significantly reduced by pairwise comparison(P<0.05). FA and λ∥ showed a downward trend as ASIA grade was reduced. ADC values increased in grade A, however decreased in grade B to D. As for λ⊥ elevation, by pairwise comparison, grade B showed significant difference from grade A, C and D(P<0.05). There was no significant difference between grade A, C or D in λ⊥ by pairwise comparison(P>0.05). DTT showed in injured area nerve fiber bundle swelling, distortion and interruption in grade A. The nerve fiber bundles were swelling, coarse and partially interrupted in grade B. Integrated nerve fiber bundles could be found in grade C and D. Comparing DWI match area with mismatch area, ADC, λ∥ decreased and λ⊥ increased significantly(P<0.05), whereas the changes of FA value had no difference(P＞0.05). DTT demonstrated that the nerve fiber bundle in DWI match area was interrupted. Conclusion: FA value and λ∥ value are sensitive indexes among different AISA grades in acute SCI. The lower the ADC value is, the more serious the injury is. DTT can display the position and injury extent of nerve fiber bundles, and provide more imaging evidence for clinical treatment.

Key words： Spinal cord injuries Diffusion magnetic resonance imaging

Received: 24 March 2016

PACS:	Ｒ651.2
	Ｒ445.2

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	Articles by authors
	ZOU Zhi-meng1
	DU Mei-ling1
	LI Jun1
	CAO Qing-yong1
	LIAN Hui-xiu1
	SHEN Xiao-jun1
	WANG Bin2

Cite this article:

ZOU Zhi-meng1,DU Mei-ling1,LI Jun1, et al. The study of DTI in acute cervical spinal injury with different ASIA grades[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(1): 8-11.

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http://www.jccmi.com.cn/EN/ OR http://www.jccmi.com.cn/EN/Y2017/V28/I1/8

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