Prediction of Neurological Recovery Using Apparent Diffusion Coefficient in Cases of Incomplete Spinal Cord Injury
Abstract BACKGROUND: Magnetic resonance imaging is useful in evaluating acute spinal cord injury. Apparent diffusion coefficient (ADC) values obtained by diffusion-weighted imaging can differentiate cytotoxic edema from vasogenic edema through microscopic motion of water protons. OBJECTIVE: To deter...
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| Veröffentlicht in: | Neurosurgery 2011-02, Vol.68 (2), p.329-336 |
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| creator | Endo, Toshiki Suzuki, Shinsuke Utsunomiya, Akihiro Uenohara, Hiroshi Tominaga, Teiji |
| description | Abstract
BACKGROUND:
Magnetic resonance imaging is useful in evaluating acute spinal cord injury. Apparent diffusion coefficient (ADC) values obtained by diffusion-weighted imaging can differentiate cytotoxic edema from vasogenic edema through microscopic motion of water protons.
OBJECTIVE:
To determine whether ADC values in the cervical spinal cord match neurological grades and thus predict functional recovery in patients suffering from cervical spinal cord injury.
METHODS:
Diffusion-weighted images were obtained using 15 axial slices covering the cervical spinal cord from 16 consecutive patients. ADC values were determined for both gray and white matter. All patients were treated surgically. Patient neurological status was evaluated preoperatively and postoperatively with the Frankel classification and neurosurgical cervical spine scale. One patient had complete spinal cord injury and showed no recovery. Using 15 patients with incomplete injury, we analyzed correlations between preoperative ADC values and neurological grading, degree of postoperative recovery, or cavity formation in follow-up magnetic resonance images. For comparison, ADC values of 11 healthy volunteers were also calculated.
RESULTS:
There was significant correlation between ADC values and degree of postoperative recovery (P = .02). ADC values of patients showing cavity formation were significantly lower than those of patients without cavity formation (0.70 vs 0.96 × 10−3 mm2/s; P = .01). The cutoff ADC value of 0.80 × 10−3 mm2/s resulted in 75% sensitivity and 81.8% specificity for predicting cavity formation.
CONCLUSION:
Low ADC values in acute spinal cord injury may indicate postoperative cavity formation in the injured spinal cord and predict poor functional recovery. |
| doi_str_mv | 10.1227/NEU.0b013e3182031ce7 |
| format | Article |
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BACKGROUND:
Magnetic resonance imaging is useful in evaluating acute spinal cord injury. Apparent diffusion coefficient (ADC) values obtained by diffusion-weighted imaging can differentiate cytotoxic edema from vasogenic edema through microscopic motion of water protons.
OBJECTIVE:
To determine whether ADC values in the cervical spinal cord match neurological grades and thus predict functional recovery in patients suffering from cervical spinal cord injury.
METHODS:
Diffusion-weighted images were obtained using 15 axial slices covering the cervical spinal cord from 16 consecutive patients. ADC values were determined for both gray and white matter. All patients were treated surgically. Patient neurological status was evaluated preoperatively and postoperatively with the Frankel classification and neurosurgical cervical spine scale. One patient had complete spinal cord injury and showed no recovery. Using 15 patients with incomplete injury, we analyzed correlations between preoperative ADC values and neurological grading, degree of postoperative recovery, or cavity formation in follow-up magnetic resonance images. For comparison, ADC values of 11 healthy volunteers were also calculated.
RESULTS:
There was significant correlation between ADC values and degree of postoperative recovery (P = .02). ADC values of patients showing cavity formation were significantly lower than those of patients without cavity formation (0.70 vs 0.96 × 10−3 mm2/s; P = .01). The cutoff ADC value of 0.80 × 10−3 mm2/s resulted in 75% sensitivity and 81.8% specificity for predicting cavity formation.
CONCLUSION:
Low ADC values in acute spinal cord injury may indicate postoperative cavity formation in the injured spinal cord and predict poor functional recovery.</description><identifier>ISSN: 0148-396X</identifier><identifier>EISSN: 1524-4040</identifier><identifier>DOI: 10.1227/NEU.0b013e3182031ce7</identifier><identifier>PMID: 21135722</identifier><identifier>CODEN: NRSRDY</identifier><language>eng</language><publisher>Hagerstown, MD: Oxford University Press</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Cervical Vertebrae ; Diffusion Magnetic Resonance Imaging ; Edema ; Female ; Humans ; Male ; Medical sciences ; Middle Aged ; Neurosurgery ; Patients ; Recovery (Medical) ; Recovery of Function ; Sensitivity and Specificity ; Spinal cord injuries ; Spinal Cord Injuries - pathology ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><ispartof>Neurosurgery, 2011-02, Vol.68 (2), p.329-336</ispartof><rights>Copyright © 2011 by the Congress of Neurological Surgeons</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-e39cfc6b85dd6db17b33ee5e14ea182380572341ac4d1b786001d113d35005523</citedby><cites>FETCH-LOGICAL-c470t-e39cfc6b85dd6db17b33ee5e14ea182380572341ac4d1b786001d113d35005523</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23794973$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21135722$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Endo, Toshiki</creatorcontrib><creatorcontrib>Suzuki, Shinsuke</creatorcontrib><creatorcontrib>Utsunomiya, Akihiro</creatorcontrib><creatorcontrib>Uenohara, Hiroshi</creatorcontrib><creatorcontrib>Tominaga, Teiji</creatorcontrib><title>Prediction of Neurological Recovery Using Apparent Diffusion Coefficient in Cases of Incomplete Spinal Cord Injury</title><title>Neurosurgery</title><addtitle>Neurosurgery</addtitle><description>Abstract
BACKGROUND:
Magnetic resonance imaging is useful in evaluating acute spinal cord injury. Apparent diffusion coefficient (ADC) values obtained by diffusion-weighted imaging can differentiate cytotoxic edema from vasogenic edema through microscopic motion of water protons.
OBJECTIVE:
To determine whether ADC values in the cervical spinal cord match neurological grades and thus predict functional recovery in patients suffering from cervical spinal cord injury.
METHODS:
Diffusion-weighted images were obtained using 15 axial slices covering the cervical spinal cord from 16 consecutive patients. ADC values were determined for both gray and white matter. All patients were treated surgically. Patient neurological status was evaluated preoperatively and postoperatively with the Frankel classification and neurosurgical cervical spine scale. One patient had complete spinal cord injury and showed no recovery. Using 15 patients with incomplete injury, we analyzed correlations between preoperative ADC values and neurological grading, degree of postoperative recovery, or cavity formation in follow-up magnetic resonance images. For comparison, ADC values of 11 healthy volunteers were also calculated.
RESULTS:
There was significant correlation between ADC values and degree of postoperative recovery (P = .02). ADC values of patients showing cavity formation were significantly lower than those of patients without cavity formation (0.70 vs 0.96 × 10−3 mm2/s; P = .01). The cutoff ADC value of 0.80 × 10−3 mm2/s resulted in 75% sensitivity and 81.8% specificity for predicting cavity formation.
CONCLUSION:
Low ADC values in acute spinal cord injury may indicate postoperative cavity formation in the injured spinal cord and predict poor functional recovery.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Cervical Vertebrae</subject><subject>Diffusion Magnetic Resonance Imaging</subject><subject>Edema</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neurosurgery</subject><subject>Patients</subject><subject>Recovery (Medical)</subject><subject>Recovery of Function</subject><subject>Sensitivity and Specificity</subject><subject>Spinal cord injuries</subject><subject>Spinal Cord Injuries - pathology</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><issn>0148-396X</issn><issn>1524-4040</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkVFr2zAUhUVZWbNs_6AMwxh9cqsryZbzGNJ2C5S2dA30zcjSVVFwLE-yB_n3U0i2Qp76JHT5ztE9OoScA70ExuTV_c3qkjYUOHKoGOWgUZ6QCRRM5IIK-oFMKIgq57Py5Yx8inFNKZRCVh_JGQPghWRsQsJjQOP04HyXeZvd4xh861-dVm32hNr_wbDNVtF1r9m871XAbsiunbVj3CkWHq112u2mLl1VxLizWXbab_oWB8x-9a5LXgsfTBqvx7D9TE6taiN-OZxTsrq9eV78zO8efiwX87tcC0mHHPlMW102VWFMaRqQDeeIBYJAlQLziqYEXIDSwkAjqzLFMymX4QWlRcH4lFzsffvgf48Yh3rjosa2VR36MdaVBF4JJspEfjsi134Mae1YM06lZCALSJTYUzr4GAPaug9uo8K2BlrvKqlTJfVxJUn29WA-Nhs0_0X_OkjA9wOgYvp2G1SnXXzjuJyJmeSJu9pzfuzf9_Rfmnei6A</recordid><startdate>20110201</startdate><enddate>20110201</enddate><creator>Endo, Toshiki</creator><creator>Suzuki, Shinsuke</creator><creator>Utsunomiya, Akihiro</creator><creator>Uenohara, Hiroshi</creator><creator>Tominaga, Teiji</creator><general>Oxford University Press</general><general>Lippincott Williams & Wilkins</general><general>Wolters Kluwer Health, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20110201</creationdate><title>Prediction of Neurological Recovery Using Apparent Diffusion Coefficient in Cases of Incomplete Spinal Cord Injury</title><author>Endo, Toshiki ; Suzuki, Shinsuke ; Utsunomiya, Akihiro ; Uenohara, Hiroshi ; Tominaga, Teiji</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-e39cfc6b85dd6db17b33ee5e14ea182380572341ac4d1b786001d113d35005523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Cervical Vertebrae</topic><topic>Diffusion Magnetic Resonance Imaging</topic><topic>Edema</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neurosurgery</topic><topic>Patients</topic><topic>Recovery (Medical)</topic><topic>Recovery of Function</topic><topic>Sensitivity and Specificity</topic><topic>Spinal cord injuries</topic><topic>Spinal Cord Injuries - pathology</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Endo, Toshiki</creatorcontrib><creatorcontrib>Suzuki, Shinsuke</creatorcontrib><creatorcontrib>Utsunomiya, Akihiro</creatorcontrib><creatorcontrib>Uenohara, Hiroshi</creatorcontrib><creatorcontrib>Tominaga, Teiji</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Endo, Toshiki</au><au>Suzuki, Shinsuke</au><au>Utsunomiya, Akihiro</au><au>Uenohara, Hiroshi</au><au>Tominaga, Teiji</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prediction of Neurological Recovery Using Apparent Diffusion Coefficient in Cases of Incomplete Spinal Cord Injury</atitle><jtitle>Neurosurgery</jtitle><addtitle>Neurosurgery</addtitle><date>2011-02-01</date><risdate>2011</risdate><volume>68</volume><issue>2</issue><spage>329</spage><epage>336</epage><pages>329-336</pages><issn>0148-396X</issn><eissn>1524-4040</eissn><coden>NRSRDY</coden><abstract>Abstract
BACKGROUND:
Magnetic resonance imaging is useful in evaluating acute spinal cord injury. Apparent diffusion coefficient (ADC) values obtained by diffusion-weighted imaging can differentiate cytotoxic edema from vasogenic edema through microscopic motion of water protons.
OBJECTIVE:
To determine whether ADC values in the cervical spinal cord match neurological grades and thus predict functional recovery in patients suffering from cervical spinal cord injury.
METHODS:
Diffusion-weighted images were obtained using 15 axial slices covering the cervical spinal cord from 16 consecutive patients. ADC values were determined for both gray and white matter. All patients were treated surgically. Patient neurological status was evaluated preoperatively and postoperatively with the Frankel classification and neurosurgical cervical spine scale. One patient had complete spinal cord injury and showed no recovery. Using 15 patients with incomplete injury, we analyzed correlations between preoperative ADC values and neurological grading, degree of postoperative recovery, or cavity formation in follow-up magnetic resonance images. For comparison, ADC values of 11 healthy volunteers were also calculated.
RESULTS:
There was significant correlation between ADC values and degree of postoperative recovery (P = .02). ADC values of patients showing cavity formation were significantly lower than those of patients without cavity formation (0.70 vs 0.96 × 10−3 mm2/s; P = .01). The cutoff ADC value of 0.80 × 10−3 mm2/s resulted in 75% sensitivity and 81.8% specificity for predicting cavity formation.
CONCLUSION:
Low ADC values in acute spinal cord injury may indicate postoperative cavity formation in the injured spinal cord and predict poor functional recovery.</abstract><cop>Hagerstown, MD</cop><pub>Oxford University Press</pub><pmid>21135722</pmid><doi>10.1227/NEU.0b013e3182031ce7</doi><tpages>8</tpages></addata></record> |
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| identifier | ISSN: 0148-396X |
| ispartof | Neurosurgery, 2011-02, Vol.68 (2), p.329-336 |
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| subjects | Adult Aged Aged, 80 and over Biological and medical sciences Cervical Vertebrae Diffusion Magnetic Resonance Imaging Edema Female Humans Male Medical sciences Middle Aged Neurosurgery Patients Recovery (Medical) Recovery of Function Sensitivity and Specificity Spinal cord injuries Spinal Cord Injuries - pathology Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases |
| title | Prediction of Neurological Recovery Using Apparent Diffusion Coefficient in Cases of Incomplete Spinal Cord Injury |
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