Role of diffusion tensor imaging and tractography in spinal cord injury

Spinal cord injuries (SCI) create significant medical and economic problems, making early diagnosis and treatment crucial. Diffusion tensor imaging (DTI) is an advanced MRI technique that assesses the spinal cord's microstructure. DTI tracks the movement of water molecules in the spinal cord's white matter. In healthy tissue, this movement is highly organized (anisotropic). Injury disrupts this organization, which DTI can detect. DTI images are analyzed using quantitative measures like fractional anisotropy (FA) and mean diffusivity (MD), as well as qualitative methods like tractography. These methods help assess the integrity and orientation of the spinal cord.

• 1
  Reduced FA is consistently observed at injury sites due to disruption of anisotropy, indicating damage to the white matter tracts.
• 2
  Diffusivity values (MD and ADC) are more variable, with studies reporting both increased and decreased values depending on the nature and stage of the injury.
• 3
  DTI can detect changes in the spinal cord distant from the primary injury site, providing a more comprehensive assessment of the impact of the injury.