急性胸段脊髓损伤MRI和DTI参数与临床预后的相关性：一项前瞻性观察研究

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-03-13 DOI:10.1016/j.jcot.2025.102975

Vishal Verma , Anil Regmi , Aakash Jain , Siddharth Shekhar Sethy , Pankaj Kandwal , Bhaskar Sarkar

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引用次数: 0

摘要

研究设计前瞻性观察性研究。目的探讨MRI与DTI参数在急性胸脊髓损伤中的相关性，以预测神经预后。印度北部大学级三级医院。方法对51例急性胸脊髓损伤患者进行常规MRI和DTIs检查。观察完全和不完全神经缺损组患者术前和术后AIS运动和感觉评分与MRI和DTI参数的关系。AIS评分、AO PROST评分和ODI评分用于脊髓功能的神经学和功能评估。将患者分为I组（ASIA A）和II组（ASIA B、C、D）。比较两组患者入院时和最终随访时MRI和DTI参数对神经学的预测价值。结果I组20例患者中，3例患者1级痊愈，6例患者2级痊愈，11例患者无痊愈。II组31例患者中有10例（33.4%）恢复到ASIA E神经病学。在单因素分析中，MOCC、SCC、脊髓肿胀长度、LOE、扭曲指数、损伤类型和血液病与出现时的完全神经功能缺损显著相关。然而，在最后的随访中，MOCC、SCC、脊髓水肿长度和血液病在预测神经学方面具有重要意义。结论最大骨管受累程度、脊髓受压程度、水肿长度、脊髓肿胀长度和血液病与神经功能缺损的预测最相关。DTI也提供优越的脊髓成像，但面临技术挑战。证据水平ii。

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Correlation between MRI and DTI parameters in acute thoracic spinal cord injury and clinical outcomes: A prospective observational study

Study design

Prospective Observational Study.

Objective

The current study aims to explore the correlation of MRI and DTI parameters in acute thoracic spinal cord injuries for prediction of neurological outcomes.

Setting

University level tertiary care hospital of Northern India.

Methods

Conventional MRI and DTIs were performed for 51 acute thoracic spinal cord injury patients. The relationship of MRI and DTI parameters with preoperative and postoperative AIS motor and sensory scores in complete and incomplete neurological deficit groups were done. AIS score, AO PROST Score and ODI score was used for neurological and functional assessment of spinal cord functions. Patients were divided into group I (ASIA A) and Group II (ASIA B, C, D). MRI and DTI parameters were compared between groups for their predictive value on neurology at admission and at final follow up.

Results

Out of 20 patients in group I, 3 patients recovered by grade 1 and 6 patients by grade 2 and no recovery in 11 patients. In group II out of 31 patients 10 patients (33.4 %) recovered to ASIA E neurology. On Univariate analysis MOCC, SCC, Length of Cord swelling, LOE, Distortion index, Type of injury and Hematomyelia were significantly associated with complete neurological deficit at presentation. However, on final follow up, MOCC, SCC, Length of cord edema, and Hematomyelia were significant in predicting neurology.

Conclusion

Maximum osseous canal compromise, Spinal Cord Compression, Length of Edema, Length of Spinal cord swelling, and hematomyelia are best correlated with prediction of a neurological deficit. DTI also provides superior spinal cord imaging but faces technical challenges.

Level of evidence

III.

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.