1
|
Porcine Model of the Growing Spinal Cord-Changes in Diffusion Tensor Imaging Parameters. Animals (Basel) 2023; 13:ani13040565. [PMID: 36830353 PMCID: PMC9951717 DOI: 10.3390/ani13040565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 01/29/2023] [Accepted: 01/31/2023] [Indexed: 02/08/2023] Open
Abstract
Diffusion tensor imaging (DTI) is an advanced magnetic resonance imaging (MRI) technique that has promising applications for the objective assessment of the microstructure of the spinal cord. This study aimed to verify the parameters obtained using DTI change during the growth process. We also wanted to identify if the DTI values change on the course of the spinal cord. The model organism was a healthy growing porcine spinal cord (19 pigs, Polish White, weight 24-120 kg, mean 48 kg, median 48 kg, age 2.5-11 months, mean 5 months, median 5.5 months). DTI parameters were measured in three weight groups: up to 29 kg (five pigs), 30-59 kg (six pigs), and from 60 kg up (eight pigs). DTI was performed with a 1.5 Tesla magnetic resonance scanner (Philips, Ingenia). Image post-processing was done using the Fiber Track package (Philips Ingenia workstation) by manually drawing the regions of interest (nine ROIs). The measurements were recorded for three sections: the cervical, thoracolumbar and lumbar segments of the spinal cord at the C4/C5, Th13/L1, and L4/L5 vertebrae levels. In each case, one segment was measured cranially and one caudally from the above-mentioned places. The values of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were obtained for each ROIs and compared. It is shown that there is a correlation between age, weight gain, and change in FA and ADC parameters. Moreover, it is noted that, with increasing weight and age, the FA parameter increases and ADC decreases, whereas the FA and ADC measurement values did not significantly change between the three sections of the spinal cord. These findings could be useful in determining the reference values for the undamaged spinal cords of animals and growing humans.
Collapse
|
2
|
Wrzosek MA, Banasik AE, Owsińska-Schmidt K, Zimny A. Diffusion Tensor Imaging in Syringomyelia Secondary to Chiari Malformation in Cavalier King Charles Spaniel-A Preliminary Study. Animals (Basel) 2022; 12:ani12233405. [PMID: 36496926 PMCID: PMC9740166 DOI: 10.3390/ani12233405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/21/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
Syringomyelia secondary to Chiari-like malformation (so-called CM-SM syndrome) is a common disorder in Cavalier King Charles Spaniels (CKCS) that is diagnosed using standard structural MRI, though imaging findings often do not correlate with the severity of clinical symptoms. Diffusion tensor imaging (DTI) is a technique that defines subtle microstructural changes in the course of many brain and spinal cord diseases, that are not visible on standard MRI. The aim of the study was to identify the correlation between the presence of clinical symptoms and DTI parameters, such as apparent diffusion coefficient (ADC) and fractional anisotropy (FA) within the spinal cord in the course of CM-SM. Study subjects included 18 dogs, CKCS with MRI-confirmed SM (SM group), and 12 CKCS dogs without SM (non-SM group). The SM group was divided into SM-symptomatic group (n = 8) and SM-asymptomatic group, n = 10). All dogs underwent same clinical and neurological assessment followed by MRI examination. All MRI studies were performed on a 1.5T MRI scanner. The MRI spine protocol included: transverse and sagittal T2-weighted images followed by DTI performed in the sagittal plane. The measurements of FA and ADC values were performed manually using the region of interest (ROI) method at the level of three intervertebral discs between C1 and C4. Notable differences in age and body weight were found. No significant differences in FA and ADC values between the SM and non-SM groups were found, but between non-SM, SM-asymptomatic and SM-symptomatic groups significant differences were found in ADC values in all three ROIs and in FA values in ROI-1 and ROI-3. SM-symptomatic dogs compared to non-SM, showed decreased FA value in ROI-1 and ROI-3 also increased ADC value in ROI-1, ROI-2 and ROI-3. SM-symptomatic dogs compared to SM-asymptomatic showed also decreased FA value in ROI-1 and ROI-3, and also increased ADC value in ROI-1, ROI-2 and ROI-3. The results suggest that the values of DTI parameters correlate with the severity of clinical symptoms in the course of CM-SM in animals. The use of DTI evaluation of CM-SM patients carries a potential value as a clinically relevant protocol for an objective assessment of the spinal cord.
Collapse
Affiliation(s)
- Marcin Adam Wrzosek
- Department of Internal Diseases with a Clinic for Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, 50-366 Wrocław, Poland
- Correspondence:
| | - Aleksandra Ewa Banasik
- Department of Internal Diseases with a Clinic for Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, 50-366 Wrocław, Poland
| | - Karolina Owsińska-Schmidt
- Department of Internal Diseases with a Clinic for Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Sciences, 50-366 Wrocław, Poland
| | - Anna Zimny
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, 50-551 Wrocław, Poland
| |
Collapse
|
3
|
Trò R, Roascio M, Tortora D, Severino M, Rossi A, Cohen-Adad J, Fato MM, Arnulfo G. Diffusion Kurtosis Imaging of Neonatal Spinal Cord in Clinical Routine. FRONTIERS IN RADIOLOGY 2022; 2:794981. [PMID: 37492682 PMCID: PMC10365122 DOI: 10.3389/fradi.2022.794981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/20/2022] [Indexed: 07/27/2023]
Abstract
Diffusion kurtosis imaging (DKI) has undisputed advantages over the more classical diffusion magnetic resonance imaging (dMRI) as witnessed by the fast-increasing number of clinical applications and software packages widely adopted in brain imaging. However, in the neonatal setting, DKI is still largely underutilized, in particular in spinal cord (SC) imaging, because of its inherently demanding technological requirements. Due to its extreme sensitivity to non-Gaussian diffusion, DKI proves particularly suitable for detecting complex, subtle, fast microstructural changes occurring in this area at this early and critical stage of development, which are not identifiable with only DTI. Given the multiplicity of congenital anomalies of the spinal canal, their crucial effect on later developmental outcome, and the close interconnection between the SC region and the brain above, managing to apply such a method to the neonatal cohort becomes of utmost importance. This study will (i) mention current methodological challenges associated with the application of advanced dMRI methods, like DKI, in early infancy, (ii) illustrate the first semi-automated pipeline built on Spinal Cord Toolbox for handling the DKI data of neonatal SC, from acquisition setting to estimation of diffusion measures, through accurate adjustment of processing algorithms customized for adult SC, and (iii) present results of its application in a pilot clinical case study. With the proposed pipeline, we preliminarily show that DKI is more sensitive than DTI-related measures to alterations caused by brain white matter injuries in the underlying cervical SC.
Collapse
Affiliation(s)
- Rosella Trò
- Departments of Informatics, Bioengineering, Robotics, and System Engineering, University of Genoa, Genoa, Italy
| | - Monica Roascio
- Departments of Informatics, Bioengineering, Robotics, and System Engineering, University of Genoa, Genoa, Italy
| | | | | | - Andrea Rossi
- Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Julien Cohen-Adad
- NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, QC, Canada
- Functional Neuroimaging Unit, CRIUGM, Université de Montréal, Montreal, QC, Canada
- Mila—Quebec AI Institute, Montreal, QC, Canada
| | - Marco Massimo Fato
- Departments of Informatics, Bioengineering, Robotics, and System Engineering, University of Genoa, Genoa, Italy
| | - Gabriele Arnulfo
- Departments of Informatics, Bioengineering, Robotics, and System Engineering, University of Genoa, Genoa, Italy
- Neuroscience Center, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| |
Collapse
|
4
|
Buyanova IS, Arsalidou M. Cerebral White Matter Myelination and Relations to Age, Gender, and Cognition: A Selective Review. Front Hum Neurosci 2021; 15:662031. [PMID: 34295229 PMCID: PMC8290169 DOI: 10.3389/fnhum.2021.662031] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 06/02/2021] [Indexed: 12/22/2022] Open
Abstract
White matter makes up about fifty percent of the human brain. Maturation of white matter accompanies biological development and undergoes the most dramatic changes during childhood and adolescence. Despite the advances in neuroimaging techniques, controversy concerning spatial, and temporal patterns of myelination, as well as the degree to which the microstructural characteristics of white matter can vary in a healthy brain as a function of age, gender and cognitive abilities still exists. In a selective review we describe methods of assessing myelination and evaluate effects of age and gender in nine major fiber tracts, highlighting their role in higher-order cognitive functions. Our findings suggests that myelination indices vary by age, fiber tract, and hemisphere. Effects of gender were also identified, although some attribute differences to methodological factors or social and learning opportunities. Findings point to further directions of research that will improve our understanding of the complex myelination-behavior relation across development that may have implications for educational and clinical practice.
Collapse
Affiliation(s)
- Irina S. Buyanova
- Neuropsy Lab, HSE University, Moscow, Russia
- Center for Language and Brain, HSE University, Moscow, Russia
| | - Marie Arsalidou
- Neuropsy Lab, HSE University, Moscow, Russia
- Cognitive Centre, Sirius University of Science and Technology, Sochi, Russia
- Department of Psychology, York University, Toronto, ON, Canada
| |
Collapse
|
5
|
Reynolds BB, By S, Weinberg QR, Witt AA, Newton AT, Feiler HR, Ramkorun B, Clayton DB, Couture P, Martus JE, Adams M, Wellons JC, Smith SA, Bhatia A. Quantification of DTI in the Pediatric Spinal Cord: Application to Clinical Evaluation in a Healthy Patient Population. AJNR Am J Neuroradiol 2019; 40:1236-1241. [PMID: 31196859 PMCID: PMC7048550 DOI: 10.3174/ajnr.a6104] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 05/16/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND PURPOSE The purpose of the study is to characterize diffusion tensor imaging indices in the developing spinal cord, evaluating differences based on age and cord region. Describing the progression of DTI indices in the pediatric cord increases our understanding of spinal cord development. MATERIALS AND METHODS A retrospective analysis was performed on DTI acquired in 121 pediatric patients (mean, 8.6 years; range, 0.3-18.0 years) at Monroe Carell Jr. Children's Hospital at Vanderbilt from 2017 to 2018. Diffusion-weighted images (15 directions; b = 750 s/mm2; slice thickness, 5 mm; in-plane resolution, 1.0 × 1.0 mm2) were acquired on a 3T scanner in the cervicothoracic and/or thoracolumbar cord. Manual whole-cord segmentation was performed. Images were masked and further segmented into cervical, upper thoracic, thoracolumbar, and conus regions. Analyses of covariance were performed for each DTI-derived index to investigate how age affects diffusion across cord regions, and 95% confidence intervals were calculated across age for each derived index and region. Post hoc testing was performed to analyze regional differences. RESULTS Analyses of covariance revealed significant correlations of age with axial diffusivity, mean diffusivity, and fractional anisotropy (all, P < .001). There were also significant differences among cord regions for axial diffusivity, radial diffusivity, mean diffusivity, and fractional anisotropy (all, P < .001). CONCLUSIONS This research demonstrates that diffusion evolves in the pediatric spinal cord during development, dependent on both cord region and the diffusion index of interest. Future research could investigate how diffusion may be affected by common pediatric spinal pathologies.
Collapse
Affiliation(s)
- B B Reynolds
- Institute of Imaging Science (B.B.R., S.B., Q.R.W., A.A.W., A.T.N., H.R.F., B.R., S.A.S., A.B.), Vanderbilt University, Nashville, Tennessee
| | - S By
- Institute of Imaging Science (B.B.R., S.B., Q.R.W., A.A.W., A.T.N., H.R.F., B.R., S.A.S., A.B.), Vanderbilt University, Nashville, Tennessee
| | - Q R Weinberg
- Institute of Imaging Science (B.B.R., S.B., Q.R.W., A.A.W., A.T.N., H.R.F., B.R., S.A.S., A.B.), Vanderbilt University, Nashville, Tennessee
| | - A A Witt
- Institute of Imaging Science (B.B.R., S.B., Q.R.W., A.A.W., A.T.N., H.R.F., B.R., S.A.S., A.B.), Vanderbilt University, Nashville, Tennessee
| | - A T Newton
- From the Department of Radiology and Radiological Sciences (A.T.N., P.C., S.A.S., A.B.).,Pediatrics (A.T.N.).,Institute of Imaging Science (B.B.R., S.B., Q.R.W., A.A.W., A.T.N., H.R.F., B.R., S.A.S., A.B.), Vanderbilt University, Nashville, Tennessee
| | - H R Feiler
- Institute of Imaging Science (B.B.R., S.B., Q.R.W., A.A.W., A.T.N., H.R.F., B.R., S.A.S., A.B.), Vanderbilt University, Nashville, Tennessee
| | - B Ramkorun
- Institute of Imaging Science (B.B.R., S.B., Q.R.W., A.A.W., A.T.N., H.R.F., B.R., S.A.S., A.B.), Vanderbilt University, Nashville, Tennessee
| | | | - P Couture
- From the Department of Radiology and Radiological Sciences (A.T.N., P.C., S.A.S., A.B.)
| | - J E Martus
- Division of Pediatric Orthopaedics (J.E.M.), Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee
| | | | - J C Wellons
- From the Department of Radiology and Radiological Sciences (A.T.N., P.C., S.A.S., A.B.).,Department of Ophthalmology (S.A.S., J.C.W. III), Vanderbilt University Medical Center, Nashville, Tennessee
| | - S A Smith
- From the Department of Radiology and Radiological Sciences (A.T.N., P.C., S.A.S., A.B.).,Department of Biomedical Engineering (S.A.S.).,Institute of Imaging Science (B.B.R., S.B., Q.R.W., A.A.W., A.T.N., H.R.F., B.R., S.A.S., A.B.), Vanderbilt University, Nashville, Tennessee.,Department of Ophthalmology (S.A.S., J.C.W. III), Vanderbilt University Medical Center, Nashville, Tennessee
| | - A Bhatia
- From the Department of Radiology and Radiological Sciences (A.T.N., P.C., S.A.S., A.B.) .,Institute of Imaging Science (B.B.R., S.B., Q.R.W., A.A.W., A.T.N., H.R.F., B.R., S.A.S., A.B.), Vanderbilt University, Nashville, Tennessee
| |
Collapse
|
6
|
Diffusion tensor imaging (DTI) and Tractography of the spinal cord in pediatric population with spinal lipomas: preliminary study. Childs Nerv Syst 2019; 35:129-137. [PMID: 30073389 DOI: 10.1007/s00381-018-3935-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 07/25/2018] [Indexed: 01/15/2023]
Abstract
PURPOSE Diffusion tensor imaging (DTI) allows studying the micro and macro architecture. One of the major challenges in dysraphism is to know the morphologic organization of the spinal cord. In a preliminary work, spinal lipoma was chosen for analyzing the micro-architecture parameters and fiber morphology of the spinal cord by DTI with tractography. METHODS Twelve patients (0-8 years) related to spinal lipomas treated between May 2017 and March 2018 were included. Tractography reconstruction of the conus medullaris of 12 patients were obtained using the MedINRIA software. The diffusion parameters have been calculated by Osirix DTImap plugin. RESULTS We found a significant difference in the FA (p = 0.024) between two age groups (< 24 months old and > 24 months old). However, no significant differences in the mean values of FA, RD, and MD between the level of the lipoma and the level above were noted. The tractography obtained in each case was coherent with morphologic sequences and reproducible. The conus medullaris was deformed and shifted. Destruction or disorganization of fibers and any passing inside the lipomas was not observed. CONCLUSIONS Tractography of the conus medullaris in a very young pediatric population (0-8 years old) with a spinal lipoma is possible, reproductive, and allows visualization of the spinal cord within the dysraphism. Analysis of the FA shows that the presence of a lipoma seems to have an effect on the myelination of the conus medullaris. It is during the probable myelination phase that the majority of symptoms appear. Is the myelination per se the cause?
Collapse
|
7
|
Alizadeh M, Fisher J, Saksena S, Sultan Y, Conklin CJ, Middleton DM, Krisa L, Finsterbusch J, Flanders AE, Faro SH, Mulcahey MJ, Mohamed FB. Age related diffusion and tractography changes in typically developing pediatric cervical and thoracic spinal cord. Neuroimage Clin 2018; 18:784-792. [PMID: 29876264 PMCID: PMC5988463 DOI: 10.1016/j.nicl.2018.03.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 03/02/2018] [Accepted: 03/14/2018] [Indexed: 12/14/2022]
Abstract
Background and objective Diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) are two techniques that can measure white matter integrity of the spinal cord. Recently, DTI indices have been shown to change with age. The purpose of this study is (a) to evaluate the maturational states of the entire pediatric spinal cord using DTI and DTT indices including fractional anisotropy (FA), mean diffusivity (MD), mean length of white matter fiber tracts and tract density and (b) to analyze the DTI and DTT parameters along the entire spinal cord as a function of spinal cord levels and age. Method A total of 23 typically developing (TD) pediatric subjects ranging in age from 6 to 16 years old (11.94 ± 3.26 (mean ± standard deviation), 13 females and 10 males) were recruited, and scanned using 3.0 T MR scanner. Reduced FOV diffusion tensor images were acquired axially in the same anatomical location prescribed for the T2-weighted images to cover the entire spinal cord (C1-mid L1 levels). To mitigate motion induced artifacts, diffusion directional images were aligned with the reference image (b0) using a rigid body registration algorithm performed by in-house software developed in Matlab (MathWorks, Natick, Massachusetts). Diffusion tensor maps (FA and MD) and streamline deterministic tractography were then generated from the motion corrected DTI dataset. DTI and DTT parameters were calculated by using ROIs drawn to encapsulate the whole cord along the entire spinal cord by an independent board certified neuroradiologist. These indices then were compared between two age groups (age group A = 6-11 years (n = 11) and age group B = 12-16 years (n = 12)) based on similar standards and age definitions used for reporting spinal cord injury in the pediatric population. Standard least squared linear regression based on a restricted maximum likelihood (REML) method was used to evaluate the relationship between age and DTI and DTT parameters. Results An increase in FA (group A = 0.42 ± 0.097, group B = 0.49 ± 0.116), white matter tract density (group A = 368.01 ± 236.88, group B = 440.13 ± 245.24) and mean length of fiber tracts (group A = 48.16 ± 20.48 mm, group B = 60.28 ± 23.87 mm) and a decrease in MD (group A = 1.06 ± 0.23 × 10-3 mm2/s, group B = 0.82 ± 0.24 × 10-3 mm2/s) were observed with age along the entire spinal cord. Statistically significant increases have been shown in FA (p = 0.004, R2 = 0.57), tract density (p = 0.0004, R2 = 0.58), mean length of fiber tracts (p < 0.001, R2 = 0.5) and a significant decrease has been shown in MD (p = 0.002, R2 = 0.59) between group A and group B. Also, it has been shown DTI and DTT parameters vary along the spinal cord as a function of intervertebral disk and mid-vertebral body level. Conclusion This study provides an initial understanding of age related changes of DTI values as well as DTT metrics of the spinal cord. The results show significant differences in DTI and DTT parameters which may result from decreasing water content, myelination of fiber tracts, and the thickening diameter of fiber tracts during the maturation process. Consequently, when quantitative DTI and DTT of the spinal cord is undertaken in the pediatric population an age and level matched normative dataset should be used to accurately interpret the quantitative results.
Collapse
Affiliation(s)
- Mahdi Alizadeh
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, United States; Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Joshua Fisher
- Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Sona Saksena
- Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Yusra Sultan
- Department of Biology, Drexel University, Philadelphia, PA, United States
| | - Chris J Conklin
- Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Devon M Middleton
- Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Laura Krisa
- Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, PA, United States
| | - Jürgen Finsterbusch
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Adam E Flanders
- Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Scott H Faro
- Department of Radiology, Johns Hopkins University, Baltimore, MD, United States
| | - M J Mulcahey
- Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, PA, United States
| | - Feroze B Mohamed
- Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States.
| |
Collapse
|
8
|
Gilli F, Chen X, Pachner AR, Gimi B. High-Resolution Diffusion Tensor Spinal Cord MRI Measures as Biomarkers of Disability Progression in a Rodent Model of Progressive Multiple Sclerosis. PLoS One 2016; 11:e0160071. [PMID: 27467829 PMCID: PMC4965026 DOI: 10.1371/journal.pone.0160071] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 07/13/2016] [Indexed: 01/02/2023] Open
Abstract
Disease in the spinal cord is a major component of disability in multiple sclerosis, yet current techniques of imaging spinal cord injury are insensitive and nonspecific. This study seeks to remove this major impediment to research in multiple sclerosis and other spinal cord diseases by identifying reliable biomarkers of disability progression using diffusion tensor imaging (DTI), a magnetic resonance imaging technique, to evaluate the spinal cord in a model of multiple sclerosis, i.e. the Theiler’s Murine Encephalitis Virus-Induced Demyelinating Disease (TMEV-IDD). Mice with TMEV-IDD with varying levels of clinical disease were imaged using a 9.4T small animal MRI scanner. Axial diffusivity, radial diffusivity, and fractional anisotropy were calculated. Disability was assessed periodically using Rotarod assay and data were expressed as a neurological function index. Correlation was performed between DTI measurements and disability scores. TMEV-IDD mice displayed significant increased neurological deficits over time when compared with controls (p<0.0001). Concurrently, the values of fractional anisotropy and axial diffusivity were both decreased compared to controls (both p<0.0001), while radial diffusivity was increased (p<0.0001). Overall, fractional anisotropy changes were larger in white matter than in grey matter and differences were more pronounced in the ventral region. Lower disability scores were associated with decreased fractional anisotropy values measured in the ventral (r = 0.68; p<0.0001) and ventral-lateral (r = 0.70; p<0.0001) regions of the white matter. These data demonstrate that DTI measures of the spinal cord contribute to strengthening the association between neuroradiological markers and clinical disability, and support the use of DTI measures in spinal cord imaging in MS patients.
Collapse
Affiliation(s)
- Francesca Gilli
- Department of Neurology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States of America
- * E-mail:
| | - Xi Chen
- Department of Radiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States of America
| | - Andrew R. Pachner
- Department of Neurology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States of America
| | - Barjor Gimi
- Department of Radiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States of America
| |
Collapse
|
9
|
Saksena S, Middleton DM, Krisa L, Shah P, Faro SH, Sinko R, Gaughan J, Finsterbusch J, Mulcahey MJ, Mohamed FB. Diffusion Tensor Imaging of the Normal Cervical and Thoracic Pediatric Spinal Cord. AJNR Am J Neuroradiol 2016; 37:2150-2157. [PMID: 27418470 DOI: 10.3174/ajnr.a4883] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 05/23/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE DTI data of the normal healthy spinal cord in children are limited compared with adults and are typically focused on the cervical spinal cord. The purpose of this study was the following: to investigate the feasibility of obtaining repeatable DTI parameters along the entire cervical and thoracic spinal cord as a function of age in typically developing pediatric subjects; to analyze the DTI parameters among different transverse levels of the cervical and thoracic spinal cord; and to examine the sex differences in DTI parameters along the cervical and thoracic spinal cord. MATERIALS AND METHODS Twenty-two subjects underwent 2 identical scans by using a 3T MR imaging scanner. Axial diffusion tensor images were acquired by using 2 overlapping slabs to cover the cervical and thoracic spinal cord. After postprocessing, DTI parameters were calculated by using ROIs drawn on the whole cord along the entire spinal cord for both scans. RESULTS An increase in fractional anisotropy and a decrease in mean diffusivity, axial diffusivity, and radial diffusivity were observed with age along the entire spinal cord. Significantly lower fractional anisotropy and higher mean diffusivity values were observed in the lower cervical cord compared with the upper cervical cord. Axial diffusivity values in the cervical cord were higher compared with the thoracic cord. No statistically significant sex differences were observed for all DTI parameters. There was a moderate-to-strong repeatability for all DTI parameters. CONCLUSIONS This study provides an initial understanding of DTI values of the spinal cord relevant to age and sex and shows that obtaining repeatable DTI values of the entire cord in children is feasible.
Collapse
Affiliation(s)
- S Saksena
- From the Departments of Radiology (S.S., F.B.M.)
| | - D M Middleton
- Department of Radiology (D.M.M., P.S., S.H.F.), Temple University, Philadelphia, Pennsylvania
| | - L Krisa
- Occupational Therapy (L.K., R.S., M.J.M.), Thomas Jefferson University, Philadelphia, Pennsylvania
| | - P Shah
- Department of Radiology (D.M.M., P.S., S.H.F.), Temple University, Philadelphia, Pennsylvania
| | - S H Faro
- Department of Radiology (D.M.M., P.S., S.H.F.), Temple University, Philadelphia, Pennsylvania
| | - R Sinko
- Occupational Therapy (L.K., R.S., M.J.M.), Thomas Jefferson University, Philadelphia, Pennsylvania
| | - J Gaughan
- Biostatistics Consulting Center (J.G.), Temple University School of Medicine, Philadelphia, Pennsylvania
| | - J Finsterbusch
- Department of Systems Neuroscience (J.F.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M J Mulcahey
- Occupational Therapy (L.K., R.S., M.J.M.), Thomas Jefferson University, Philadelphia, Pennsylvania
| | - F B Mohamed
- From the Departments of Radiology (S.S., F.B.M.)
| |
Collapse
|
10
|
Diffusion tensor imaging of the cervical spinal cord in children. Childs Nerv Syst 2015; 31:1239-45. [PMID: 26036198 DOI: 10.1007/s00381-015-2767-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 05/22/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Obtaining fast, reliable, high-resolution diffusion tensor imaging (DTI) of the pediatric cervical spinal cord (CSC) is challenging, given the multitude of technical limitations involved. Overcoming these limitations may further potentiate DTI as a valuable quantitative tool in evaluating the pediatric CSC. METHODS Sixteen patients (9 girls and 7 boys) with hypoxic brain injury, craniocervical junction malformations, and head trauma were included in this retrospective study. Region of interests were placed from C1-C2 through C7-T1 consecutively at the cervical intervertebral disc levels. DTI metrics were compared with a pediatric DTI database of healthy controls. Clinical background and outcomes were tabulated. RESULTS Patients with hypoxic brain injury, Chiari I and II malformations, and head trauma demonstrated lower fractional anisotropy values than that of healthy controls at certain cervical intervertebral disc levels. CONCLUSIONS DTI may be a promising modality for providing additional information beyond that of conventional magnetic resonance imaging in pediatric central nervous system disorders.
Collapse
|
11
|
Du H, Xie B, Lu P, Feng H, Wang J, Yuan S. Impaired white-matter integrity in photosensitive epilepsy: A DTI study using tract-based spatial statistics. J Neuroradiol 2014; 41:131-5. [DOI: 10.1016/j.neurad.2013.06.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2012] [Revised: 05/28/2013] [Accepted: 06/13/2013] [Indexed: 11/27/2022]
|
12
|
Diffusion tensor imaging to guide surgical planning in intramedullary spinal cord tumors in children. Neuroradiology 2014; 56:169-74. [PMID: 24395215 DOI: 10.1007/s00234-013-1316-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Accepted: 12/20/2013] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Intramedullary spinal cord neoplasms (ISCN) in children provide diagnostic, treatment and management dilemmas. Resection results in the best chance for disease control, but the greatest risk of neurologic deficit. We hypothesize that diffusion tensor imaging (DTI) and diffusion tensor-fiber tracking (DT-FT) can help characterize margins of pediatric ISCN to aid in surgical planning. METHODS This HIPAA compliant retrospective study was performed after Institutional Review Board approval. Patients with ISCN from a single tertiary care pediatric institution were identified, and patients with preoperative DTI were evaluated. RESULTS Ten patients (eight males and two females) with ISCN with preoperative DTI were identified. The mean age was 11.1 ± 6.2 years (range, 2-18 years). Eight tumors demonstrated DTI and DT-FT evidence of splayed cord tracts, and two demonstrated evidence of infiltration of cord tracts. The eight patients with splayed tracts underwent resection, with seven achieving gross-total resection and one subtotal resection. The two patients with infiltration of white matter tracts underwent biopsy of their lesion. CONCLUSIONS DTI of pediatric ISCN can aid in defining the margins of the tumor and relationship to the intrinsic white matter structures of the spinal cord. Splaying and displacement of fiber tracts appears to predict a discrete margin to the tumor and resectability, whereas infiltration of the white matter tracts suggests biopsy may be more advisable.
Collapse
|
13
|
Kamiya K, Sato N, Ota M, Nakata Y, Ito K, Kimura Y, Murata M, Mori H, Kunimatsu A, Ohtomo K. Diffusion tensor tract-specific analysis of the uncinate fasciculus in patients with progressive supranuclear palsy. J Neuroradiol 2013; 40:121-9. [DOI: 10.1016/j.neurad.2012.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Revised: 05/29/2012] [Accepted: 06/23/2012] [Indexed: 12/14/2022]
|
14
|
Rao JS, Zhao C, Yang ZY, Li SY, Jiang T, Fan YB, Li XG. Diffusion tensor tractography of residual fibers in traumatic spinal cord injury: a pilot study. J Neuroradiol 2013; 40:181-6. [PMID: 23428240 DOI: 10.1016/j.neurad.2012.08.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Revised: 08/01/2012] [Accepted: 08/23/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE In clinical studies, evaluating residual fiber tracts in spinal cord injuries poses serious difficulties, whereas diffusion tensor imaging (DTI) can assess alterations in fiber structural integrity. For this reason, this study aimed to determine changes in the structural integrity of residual fiber tracts via fractional anisotropy (FA) variations and fiber-tracking patterns in patients with chronic traumatic spinal cord injury (SCI). MATERIALS AND METHODS T2-weighted and diffusion-weighted imaging was performed on four traumatic SCI patients and three healthy volunteers using a 3.0-T MR scanner. After obtaining fiber-tracking maps, FA values were measured and analyzed in residual and remote normal and healthy cords. RESULTS Diffusion tensor tractography showed obvious destruction of fiber tracts in injured cords. In the healthy control subjects, averaged FA values ranged from 0.545 to 0.601, whereas all SCI patients had decreased FA values in both residual (0.220 ± 0.121) and remote normal fibers (0.535 ± 0.101). There were also statistically significant differences in FA values between residual and remote normal fibers in patients (P = 0.000) and between their residual and healthy control fibers (P = 0.000). No significant difference was found between remote normal and healthy cords (P = 0.312). CONCLUSION Specific FA variations were observed in residual fibers, suggesting that DTI may be a useful tool for evaluating residual tracts in SCI patients.
Collapse
Affiliation(s)
- Jia-Sheng Rao
- Department of Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, 37# Xueyuan Road, 100191 Beijing, China
| | | | | | | | | | | | | |
Collapse
|