Diffusion tensor imaging of spinal cord in healthy children

Introduction. Diffusion tensor imaging (DTI) is a technique that allows evaluating diffusion of water molecules along the myelin sheath of nerve fibers and obtaining information about the integrity of brain and spinal cord pathways. Obtaining reproducible values of diffusion parameters is an urgent and feasible task. The aim of this study was to establish the values of DTI parameters along the entire length of the spinal cord in healthy children for further use in the assessment of acute injury, its consequences and other spinal cord diseases.

Materials and methods. The study included fifteen healthy patients of 13 to 18 years, including 6 girls and 8 boys, average age was 15.2 ± 1.2 years. The study was performed on a Philips Achieva dStream 3T MRI scanner (Netherlands). As part of this study, a spine MRI protocol was developed to cover the entire volume of spinal cord with separate visualization of cervical and thoracic spine (duration: 9 min 48 sec). The IRIS ZOOM sequence (Philips) was used to obtain DTI images. Spinal Cord Toolbox software package was used to process the data. Statistical analysis was performed using GraphPad Prism software, and significance was determined at p < 0.05.

Results. Mapping and calculation of the following diffusion parameters: fractional anisotropy (FA), medial (MD), longitudinal or axial (AD) and transverse (RD) diffusion showed the average values of the parameters FA, AD, MD, RD of the spinal cord of children to be: FA, AD, MD, RD of spinal cord were: FA = 0.63 ± 0.06, AD = 2.1 ± 0.3 × 10⁻³ mm²/s, MD = 1.15 ± 0.16 × 10⁻³ mm²/s, RD = 0.68 ± 0.12 × 10⁻³ mm²/s. An increase in FA was detected at the Th2–Th9 level compared to the values at the C6–Th1 and Th10–Th12 levels. The AD coefficient at the Th2–Th9 level is increased relative to the C2–C5 and C6–Th1 levels. MD values in spinal cord areas at the Th2–Th9 and Th10–Th12 levels are statistically higher relative to higher levels of the spinal cord. RD values in the zone at the Th10–Th12 level are increased relative to all other areas.

Conclusion. The study established the diffusion indices of FA, MD, AD, RD of spinal cord in children aged 12 to 18 years and showed small differences between the spinal cord regions. The data obtained can be used as reference values for assessing spinal cord condition in various pathological processes (trauma, demyelinating and tumor diseases) in children for the corresponding age group.

Contribution:
Akhadov T.A., Bozhko O.V., Ublinskiy M.V. — research concept and design;
Bozhko O.V., Ublinskiy M.V., Kobzeva A.A., Melnikov I.A. — conducting research;
Bozhko O.V., Ublinskiy M.V., Voronkova E.V. — collection and analysis of data;
Ublinskiy M.V., Voronkova E.V. — statistical analysis;
Bozhko O.V. — writing the text;
Akhadov T.A., Ublinskiy M.V. — editing the text;
Akhadov T.A., Bozhko O.V., Ublinzkiy M.V. — approval of the final version of the article.
All co-authors — responsibility for the integrity of all parts of the article.

Acknowledgment. The study was supported by grant from the Moscow Department of Health No. 2112-9/22.

Conflict of interest. The authors declare no conflict of interest.

Received: September 27, 2024
Accepted: October 08, 2024
Published: November 12, 2024

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