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Using diffusion tensor imaging to assess children with spinal cord injury without fracture or dislocation

Spinal Cord volume 63, pages 342–347 (2025) Cite this article

Subjects

Abstract

Study design

Cross-sectional study.

Objectives

This study investigates changes in spinal DTI metrics above lesion in children with spinal cord injury without fracture or dislocation (SCIWOFD), aiming to assess DTI’s potential as a diagnostic and evaluative tool for SCIWOFD in children.

Setting

Xuanwu Hospital, Capital Medical University, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, China.

Methods

This study included 18 children with SCIWOFD and 12 typically developing (TD) children. SCIWOFD children underwent International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) assessments and MRI with axial spinal cord DTI. DTI data were processed with Diffusion Toolkit and TrackVis, with four levels above the lesion (Level 1 to Level 4). Spinal DTI metrics were extracted, and statistical analysis was performed using multiple linear regression and Pearson correlation.

Results

Compared to the TD group, the SCIWOFD group displayed significant changes in DTI metrics at four spinal cord levels. At level 1, FA decreased (p < 0.000), while MD (p < 0.000), AD (p = 0.007), and RD (p < 0.000) increased. Levels 2 and 3 showed decreased FA (level 2: p < 0.000; level 3: p = 0.001) and increased MD (level 2: p = 0.001; level 3: p = 0.029) and RD values (level 2: p < 0.000; level 3:p = 0.001). At level 4, FA decreased (p < 0.000), while RD increased (p = 0.009). At level 1 in the SCIWOFD group, MD (r = −0.534, p = 0.022) and RD (r = −0.569, p = 0.009) correlated with sensory scores.

Conclusions

Spinal DTI metrics above the lesion in children with SCIWOFD exhibit gradient changes, with a statistically correlation between the DTI metrics at the rostral edge of the lesion and ISNCSCI sensory scores. DTI metrics may serve as stable, objective indicators for assessing SCIWOFD in children.

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Fig. 1: Illustration of ROIs placement.
The alternative text for this image may have been generated using AI.
Fig. 2: Comparison of spinal cord DTI metrics between the two groups.
The alternative text for this image may have been generated using AI.
Fig. 3: Correlation analysis between spinal cord DTI metrics and ISNCSCI scores in children with SCIWOFD.
The alternative text for this image may have been generated using AI.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding authors on request.

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Acknowledgements

The authors thank the patients and healthy volunteers who participated in this study.

Funding

This study was funded by the National Natural Science Foundation of China (Grants Nos. 81871339 and 81271556), the Beijing Municipal Natural Science Foundation (Grant No. 7113155), and the Science Foundation of the Beijing Municipal Commission of Education (Grant No. KM201210025013). The funding organizations had no involvement in the study design, data collection and analysis, decision to publish, or manuscript preparation.

Author information

Authors and Affiliations

  1. Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China

    Qunya Qi, Beining Yang, Yulong Jia, Yu Wang, Haotian Xin, Xianglin Guo, Xin Chen, Jie Lu & Nan Chen

  2. Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, 100053, China

    Qunya Qi, Beining Yang, Yulong Jia, Yu Wang, Haotian Xin, Xianglin Guo, Xin Chen, Jie Lu & Nan Chen

  3. Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China

    Ling Wang & Qian Chen

  4. Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China

    Weimin Zheng

  5. Department of Rehabilitation Medicine, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China

    Fang Li & Jubao Du

Authors
  1. Qunya Qi
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  2. Ling Wang
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Contributions

QQ contributed to the study design, statistical analysis, and drafting of the manuscript. NC was involved in conceptualizing the research, writing the review, and editing the manuscript. LW, BY, YJ, YW, HX, XG, WZ, XC, QC, FL, JD, and JL participated in data collection, extraction, and analysis.

Corresponding author

Correspondence to Nan Chen.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethical approval

Ethical approval for this study was granted by the Ethics Committee of Xuanwu Hospital, Capital Medical University (Ethics No: [2020] 003), and the study was registered as a clinical trial (Registration No: ChiCTR2000032793).

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Cite this article

Qi, Q., Wang, L., Yang, B. et al. Using diffusion tensor imaging to assess children with spinal cord injury without fracture or dislocation. Spinal Cord 63, 342–347 (2025). https://doi.org/10.1038/s41393-025-01091-z

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