RT Journal Article
SR Electronic
T1 MRI Atlas-Based Measurement of Spinal Cord Injury Predicts Outcome in Acute Flaccid Myelitis
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 410
OP 417
DO 10.3174/ajnr.A5044
VO 38
IS 2
A1 D.B. McCoy
A1 J.F. Talbott
A1 Michael Wilson
A1 M.D. Mamlouk
A1 J. Cohen-Adad
A1 Mark Wilson
A1 J. Narvid
YR 2017
UL http://www.ajnr.org/content/38/2/410.abstract
AB BACKGROUND AND PURPOSE: Recent advances in spinal cord imaging analysis have led to the development of a robust anatomic template and atlas incorporated into an open-source platform referred to as the Spinal Cord Toolbox. Using the Spinal Cord Toolbox, we sought to correlate measures of GM, WM, and cross-sectional area pathology on T2 MR imaging with motor disability in patients with acute flaccid myelitis.MATERIALS AND METHODS: Spinal cord imaging for 9 patients with acute flaccid myelitis was analyzed by using the Spinal Cord Toolbox. A semiautomated pipeline using the Spinal Cord Toolbox measured lesion involvement in GM, WM, and total spinal cord cross-sectional area. Proportions of GM, WM, and cross-sectional area affected by T2 hyperintensity were calculated across 3 ROIs: 1) center axial section of lesion; 2) full lesion segment; and 3) full cord atlas volume. Spearman rank order correlation was calculated to compare MR metrics with clinical measures of disability.RESULTS: Proportion of GM metrics at the center axial section significantly correlated with measures of motor impairment upon admission (r [9] = −0.78; P = .014) and at 3-month follow-up (r [9] = −0.66; P = .05). Further, proportion of GM extracted across the full lesion segment significantly correlated with initial motor impairment (r [9] = −0.74, P = .024). No significant correlation was found for proportion of WM or proportion of cross-sectional area with clinical disability.CONCLUSIONS: Atlas-based measures of proportion of GM T2 signal abnormality measured on a single axial MR imaging section and across the full lesion segment correlate with motor impairment and outcome in patients with acute flaccid myelitis. This is the first atlas-based study to correlate clinical outcomes with segmented measures of T2 signal abnormality in the spinal cord.%CSAproportion of cross-sectional area%GMproportion of gray matter%WMproportion of white matterAFMacute flaccid myelitisEVenterovirusMRCMedical Research CouncilSCspinal cordSCTSpinal Cord Toolbox