Abstract:

Objective   To observe the correlation between features of diffusion tension imaging (DTI) and Japanese Orthopaedic Association (JOA) scores in patients with cervical spinal cord injury without radiographic abnormality (CSCIWORA). Methods   31 CSCIWORA patients were assessed and divided into 4 stages according to JOA scores. The score of stage Ⅰ/Ⅱ/Ⅲ/Ⅳ was 16-13, 12-9, 8-5 and less than 4 respectively. All the patients accepted conventional scan and DTI. The Fractional Anisotropy (FA) and Apparent Diffusion Coefficient (ADC) were measured respectively, and the correlation to JOA scores was observed. Results   Stage Ⅰ: FA was slightly lower, ADC was slightly higher; Stage Ⅱ: FA was lower, ADC was higher; Stage Ⅲ: FA was significantly lower, ADC was confounding; Stage Ⅳ: FA was the lowest, ADC was lower. FA was related to JOA score of patients with CSCIWORA(P=0.000 ), ADC was not evidently related to JOA scores of patients with CSCIWORA(P=0.802 ). Conclusion   DTI could show the pathophysiology process of CSCIWORA more directly and more efficiently. It is suggested that DTI can provide valuable information about injury degree of cervical spinal cord and prognosis evaluation.

Key words:  Cervical spinal cord injury without radiographic abnormality; Diffusion tension imaging; Fractional anisotropy; Apparent diffusion coefficient; Japanese orthopaedic association scores