Completed Research Studies

1. Title: Value of Magnetic Resonance Imaging (MRI) and Diffusion Tensor Imaging (DTI) as Biomarkers for Classifying Acute Spinal Cord Injury

Purpose: The purpose of this project is to develop a novel objective method to assess the extent of neurologic damage in acute spinal cord injury (SCI) utilizing advanced MR imaging techniques. The neurologic exam at presentation (AIS), conventional MRI feature designators of lesion length and location, and additional MRI metrics provided by diffusion tensor imaging (DTI) will be assessed to determine which variables or combination of variables best predicts clinical outcome, as defined by neurological examinations at 1 week, 2 weeks, 3 months and 6 months.

Principal Investigator: Adam E. Flanders, MD
Co-Investigator(s): Ralph J. Marino, MD; Christina V. Oleson, MD

Background: Currently, MRI provides the only means to directly inspect the damaged spinal cord, therefore it has the potential to complement the assessment provided by the subjective neurologic examination in gauging the degree of injury in SCI. Moreover, MRI evaluation is not operator dependant and the assessment of the MRI features is reproducible among observers. MRI provides excellent definition of intramedullary hemorrhage and edema in animal models. The combination of MRI lesion length, cord caliber, and degree of preservation of white matter in MRI cross-section has a significant relationship to functional status in animals and the pathologic findings at autopsy. The MRI appearance of experimentally induced SCI has been used to explain the variability in functional deficit among animals subjected to identical injuries.

A significant shortcoming of MRI is its limited capability in demonstrating functionally preserved white matter tracts at the level of injury; this observation becomes significant in estimating preserved functional capacity. With the advent of diffusion techniques and tractography algorithms based upon diffusion parameters, MRI now has the capacity to assess the integrity of spinal white matter.

The goal of this proposal is to determine if the metrics derived from conventional MRI and DTI in conjunction with the neurological exam can serve as a reliable objective biomarker for determination of the extent of neurologic injury and early identification of patients who would benefit from treatment.

Study Dates: September 1, 2010 - September 29, 2014

Status: Study Completed

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