Spinal Cord Trauma

Knowing the limitations of conventional MRI techniques in estimation of the extent of Spinal cord injury (SCI), there is a need for the evaluation of new techniques. DWI has been first evaluated in animal studies showing promising results.37 The comparison of conventional T2-weighted images and DWI in acute SCI showed comparable detection rates for spinal cord damage in 18 patients within 24 hours postinjury.38 The detection rates of high signals on T2-weighted and DWI did not show significant differences, being 94 and 72%, respectively.38 In another study, conventional MRI and multishot, navigator-corrected DWI were performed in 20 patients with acute spinal cord trauma using 1.5 T MRI within 72 h after the onset of trauma.39 In that study 20 cases were classified into four types: edema type (10 cases), mixed type (6 cases), hemorrhage type (2 cases), and compressed type (2 cases). DWI hyperintensity was detected in edema cases, most probably representing cytotoxic edema, as well as in two patients with cord compression. Inhomogeneous signals were seen in patients with mixed-type injury. An important limitation of the study is the lack of axial DWI images, lack of normal controls, and low b values (400 and 500 s/mm2) used.39

Clinical Rationale for DWI/DTI in Traumatic Spinal Cord Injury

  • • Not yet part of the routine protocols
  • • Promising technique for evaluation of injury epicenter, differentiation of injured and normal spinal cord in the absence of T2-signal changes
 
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