Diffusion tensor tractography of residual fibers in traumatic spinal cord injury: A pilot study

Background and purpose: In clinical studies, evaluating residual fiber tracts in spinal cord injuries poses serious difficulties, whereas diffusion tensor imaging (DTI) can assess alterations in fiber structural integrity. For this reason, this study aimed to determine changes in the structural integrity of residual fiber tracts via fractional anisotropy (FA) variations and fiber-tracking patterns in patients with chronic traumatic spinal cord injury (SCI). Materials and methods: T2-weighted and diffusion-weighted imaging was performed on four traumatic SCI patients and three healthy volunteers using a 3.0-T MR scanner. After obtaining fiber-tracking maps, FA values were measured and analyzed in residual and remote normal and healthy cords. Results: Diffusion tensor tractography showed obvious destruction of fiber tracts in injured cords. In the healthy control subjects, averaged FA values ranged from 0.545 to 0.601, whereas all SCI patients had decreased FA values in both residual (0.220 ± 0.121) and remote normal fibers (0.535 ± 0.101). There were also statistically significant differences in FA values between residual and remote normal fibers in patients (P= 0.000) and between their residual and healthy control fibers (P= 0.000). No significant difference was found between remote normal and healthy cords (P= 0.312). Conclusion: Specific FA variations were observed in residual fibers, suggesting that DTI may be a useful tool for evaluating residual tracts in SCI patients.