Prediction of neurological prognosis of patients with acute traumatic cervical spinal cord injury using Neurite Orientation Dispersion and Density Imaging (NODDI).

INTRODUCTION

We applied an advanced diffusion model of Neurite Orientation Dispersion and Density Imaging (NODDI) to patients with acute traumatic cervical spinal cord injury and investigated the correlation of NODDI metrics with clinical symptoms and neurological prognosis.

MATERIALS AND

METHODS

We enrolled 13 patients (mean age, 66.6 [48-80] years) who were admitted to our hospital with acute traumatic cervical spinal cord injury. Magnetic resonance imaging (MRI) diffusion-weighted images were acquired for 13 patients 6.4 ± 1.7 days post-injury and 10 healthy volunteers (mean age, 67.0 [53-79] years). Fractional anisotropy (FA), intracellular volume fraction (ICVF), isotropic volume fraction (ISO), and orientation dispersion index (ODI) were calculated at the level of the injury in patients and at C3/4, C4/5, and C5/6 in healthy volunteers. We assessed the American Spinal Injury Association International Standards Neurological Classification of Spinal Cord Injury (ASIA) motor score at injury onset and at 6 months and 1 year post-injury.

RESULTS

Patients had significantly lower FA and higher ODI values than healthy volunteers. FA and ODI values were significantly correlated with the ASIA motor scores at onset and at 1 year post-injury. ODI demonstrated the highest correlation with the ASIA motor score at 1 year post-injury. Complete recovery of muscle weakness occurred in all six cases with ODI values <0.12, while muscle weakness persisted in six of seven cases with ODI values >0.12.

CONCLUSIONS

ODI is a relevant predictor of motor function at 1 year post-injury.