Predictive values of spinal cord diffusion magnetic resonance imaging to characterize outcomes after contusion injury

Author:

Ahmed Rakib Uddin1ORCID,Medina‐Aguinaga Daniel2,Adams Shawns3,Knibbe Chase A.1,Morgan Monique1,Gibson Destiny1,Kim Joo‐won45,Sharma Mayur1,Chopra Manpreet1,Davison Steven6,Sherwood Leslie C.6,Negahdar M.J.7,Bert Robert7,Ugiliweneza Beatrice1,Hubscher Charles2,Budde Matthew D.89,Xu Junqian45ORCID,Boakye Maxwell1

Affiliation:

1. Department of Neurological Surgery and Kentucky Spinal Cord Injury Research Center University of Louisville Louisville Kentucky USA

2. Department of Anatomical Sciences and Neurobiology University of Louisville Louisville Kentucky USA

3. Department of Neurosurgery Duke University Raleigh North Carolina USA

4. Department of Radiology Baylor College of Medicine Houston Texas USA

5. Department of Psychiatry Baylor College of Medicine Houston Texas USA

6. Comparative Medicine Research Unit University of Louisville Louisville Kentucky USA

7. Department of Radiology University of Louisville Louisville Kentucky USA

8. Department of Neurosurgery Medical College of Wisconsin Milwaukee Wisconsin USA

9. Clement J. Zablocki Veterans Affairs Medical Center Milwaukee Wisconsin USA

Abstract

AbstractObjectivesTo explore filtered diffusion‐weighted imaging (fDWI), in comparison with conventional magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI), as a predictor for long‐term locomotor and urodynamic (UD) outcomes in Yucatan minipig model of spinal cord injury (SCI). Additionally, electrical conductivity of neural tissue using D‐waves above and below the injury was measured to assess correlations between fDWI and D‐waves data.MethodsEleven minipigs with contusion SCI at T8‐T10 level underwent MRI at 3T 4 h. post‐SCI. Parameters extracted from region of interest analysis included Daxial from fDWI at injury site, fractional anisotropy and radial diffusivity from DTI above the injury site along with measures of edema length and cord width at injury site from T2‐weighted images. Locomotor recovery was assessed pre‐ and weekly post‐SCI through porcine thoracic injury behavior scale (PTIBS) and UD were performed pre‐ and at 12 weeks of SCI. D‐waves latency and amplitude differences were recorded before and immediately after SCI.ResultsTwo groups of pigs were found based on the PTIBS at week 12 (p < 0.0001) post‐SCI and were labeled “poor” and “good” recovery. D‐waves amplitude decreased below injury and increased above injury. UD outcomes pre/post SCI changed significantly. Conventional MRI metrics from T2‐weighted images were significantly correlated with diffusion MRI metrics. Daxial at injury epicenter was diminished by over 50% shortly after SCI, and it differentiated between good and poor locomotor recovery and UD outcomes.InterpretationSimilar to small animal studies, fDWI from acute imaging after SCI is a promising predictor for functional outcomes in large animals.

Funder

National Institutes of Health

Publisher

Wiley

Subject

Neurology (clinical),General Neuroscience

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