DIFFUSION-WEIGHTED IMAGES AND DIFFUSION TENSOR TRACTOGRAPHY OF THE SPINAL CORD IN CHILDREN: THE RELATIONSHIP BETWEEN THE LEVEL OF FRACTIONAL

ANISOTROPY AND THE CLINICAL PICTURE OF SPINAL CORD INJURY

 

Sysoev K.V.¹, Kostitsyna E.A.¹, Nazinkina Yu.V.¹, Efimtcev A. Yu.¹,

Kulaeva A.A.¹, Trofimova T.N.²

 

1 – Almazov National Medical Research Centre. Saint Petersburg, Russia.

2 – Institute of the Human Brain, Russian Academy of Sciences. Saint Petersburg, Russia.

P

urpose. To identify the potential relationship of fractional anisotropy (FA) indices during MRI in the mode of diffusion-weighted images (DVI) and diffusion tensor tractography (DTT) with the clinical picture of spinal cord damage in various pathologies of the spinal cord in children.

Materials and methods. A total of 68 consecutive pediatric patients (2 months – 18 years old) with different spinal cord abnormalities underwent standard spinal cord MRI supplemented by DTI and Tractography. Neurological examination assessed the degree (paresis/paralysis) and characteristics (flaccid/spastic) of motor deficit. Clinical and MRI data were compared in order to identify statistically significant correlations.

Results. It was found that a decrease in FA values at the level of the caudal spinal cord of less than 0.3 was associated with the presence of flaccid paralysis of the lower extremities, regardless of the child's age (P <0.00001). In syringomyelia or diastomatomyelia, the decrease in FA values did not correspond to the severity of clinical symptoms.

Discussion. FA values vary at different levels of the spinal cord. The FA values of the caudal spinal cord are 50% lower than at the rostral levels, and usually do not exceed 0.4. In our study, in the pathology of the caudal spinal cord, segmental dysfunction was observed with a decrease in the FA level of less than 0.3, while maintaining the construction of tracts in the DTT mode.

Conclusion. Analysis of spinal cord FA values in various pathologies can provide additional information about the severity of its damage and the prognosis of the disease.

 

Keywords: Neuroimaging, Diffusion Tensor Imaging, Diffusion Tensor Tractography, Spinal Cord, Spinal Dysraphism.

 

Corresponding author: Kulaeva A.A., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Sysoev K.V., Kostitsyna E.A., Nazinkina Yu.V., Efimtcev A. Yu., Kulaeva A.A., Trofimova T.N. Diffusion-weighted images and diffusion tensor tractography of the spinal cord in children: the relationship between the level of fractional anisotropy and the clinical picture of spinal cord injury. REJR 2025; 15(3):197-210. DOI: 10.21569/2222-7415-2025-15-3-197-210.

Received:        15.09.25                 Accepted: 30.10.25