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Filter-Probe Diffusion Imaging Improves Spinal Cord Injury Outcome Prediction
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7 2018
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Source: Ann Neurol. 84(1):37-50
[PDF-1.37 MB]
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Alternative Title:Ann Neurol
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Description:Objective
Diffusion weighted imaging (DWI) is a powerful tool for investigating spinal cord injury (SCI), but has limited specificity for axonal damage- the most predictive feature of long-term functional outcome. In this study, a technique designed to detect acute axonal injury, filter-probe double diffusion encoding (FP-DDE) is compared with standard DWI for predicting long-term functional and cellular outcomes.
Methods
This study extends FP-DDE to predict long-term functional and histological outcomes in a rat SCI model of varying severities(n=58). Using a 9.4T MR system, a whole-cord FP-DDE spectroscopic voxel was acquired in three minutes at the lesion site and compared to DWI at 48 hours post-injury. Relationships with chronic (30-day) locomotor and histological outcomes were evaluated with linear regression.
Results
The FP-DDE measure of parallel diffusivity (ADC||) was significantly related to chronic hind limb locomotor functional outcome (R2=0.63, p<0.0001) and combining this measurement with acute functional scores demonstrated prognostic benefit versus functional testing alone (p=0.0007). Acute ADC|| measurements were also more closely related to the number of injured axons measured 30 days after the injury than standard DWI. Furthermore, acute FP-DDE images showed a clear and easily interpretable pattern of injury that closely corresponded chronic MRI and histology observations.
Interpretation
Collectively, these results demonstrate FP-DDE benefits from greater specificity for acute axonal damage in predicting functional and histological outcomes with rapid acquisition and fully automated analysis, improving over standard DWI. FP-DDE is a promising technique compatible with clinical settings with potential research and clinical applications for evaluation of spinal cord pathology.
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Pubmed ID:29752739
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Pubmed Central ID:PMC6119508
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