Role of conventional MRI and MR diffusion tensor imaging in cervical spine trauma: A comprehensive evaluation of the cervical cord

Shanmathi R, Kalaivani P, Bhuvaneswari KA, Murali N, Vasumathy S

Pdf Page Numbers :- 126-130

Shanmathi R^1,*, Kalaivani P², Bhuvaneswari KA², Murali N² and Vasumathy S²

¹Department of Radiodiagnosis, Swamy Vivekanandha Medical College Hospital and Research Institute, Tiruchengode, Tamil Nadu 637205, India

²Department of Radiodiagnosis, Coimbatore Medical College, Coimbatore Medical College, Coimbatore, Tamil Nadu 641018, India

*Corresponding author: Dr. Shanmathi R, Assistant Professor, Department of Radiodiagnosis, Swamy Vivekanandha Medical College Hospital and Research Institute, Tiruchengode, Tamil Nadu 637205, India. Email: shanmathiram22@gmail.com

Received 3 December 2024; Revised 18 February 2025; Accepted 1 March 2025; Published 10 March 2025

Citation: Shanmathi R, Kalaivani P, Bhuvaneswari KA, Murali N, Vasumathy S. Role of conventional MRI and MR diffusion tensor imaging in cervical spine trauma: A comprehensive evaluation of the cervical cord. J Med Sci Res. 2025; 13(2):126-130. DOI: http://dx.doi.org/10.17727/JMSR.2024/13-22

Copyright: © 2025 Shanmathi R et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Background: Cervical spine trauma was a critical clinical condition requiring accurate assessment for optimal management. This study aims to evaluate the role of Diffusion Tensor Imaging (DTI) and fiber tractography, alongside conventional MRI, in assessing cervical spinal cord injury (SCI). The objective was to analyse in vivo microstructural parameters—Fractional Anisotropy (FA) and Apparent Diffusion Coefficient (ADC)—using region of interest (ROI) analysis and to compare these parameters with conventional MRI findings for early detection of axonal injury.

Method: This hospital-based prospective observational study included 50 patients referred to the Department of Radio-Diagnosis for cervical spine MRI with clinical suspicion or confirmation of cervical spine trauma during 2022. Imaging was performed using a 1.5T Siemens Amira MR unit.

Results: The mean length of cord involvement was 3.39 cm on conventional MRI and 5.28 cm on DTI/MR tractography, a statistically significant difference. Patients with some or good clinical improvement had normal or increased ADC values, while those with decreased ADC showed no improvement. ADC was significantly reduced in cases of acute traumatic spinal cord injury (TSCI) and spinal cord haemorrhage. Although no strong correlation was found between FA values and clinical recovery, mean FA values were consistently lower in all cord pathologies, including swelling, contusion, haemorrhage, and transection.

Conclusion: DTI, with its quantitative indices, enhances the assessment of traumatic cervical spinal cord injury. Compared to conventional MRI, it provides additional valuable information. Incorporating DTI into routine imaging protocols may improve diagnostic accuracy and guide clinical management in spinal trauma.

Keywords: spinal cord injury; MRI; DTI; fractional anisotropy; apparent diffusion coefficient