BACKGROUND Percutaneous endoscopic lumbar decompression(PELD)shows promise for lumbar spinal stenosis(LSS)treatment,but its use is limited by the disease's complexity and procedural challenges.AIM In this study,th...BACKGROUND Percutaneous endoscopic lumbar decompression(PELD)shows promise for lumbar spinal stenosis(LSS)treatment,but its use is limited by the disease's complexity and procedural challenges.AIM In this study,the effects of preoperative planning and intraoperative guidance with computed tomography(CT)/magnetic resonance imaging(MRI)registration techniques on PELD for LSS and postoperative rehabilitation outcomes were evaluated.METHODS This retrospective study was conducted with data from patients who underwent PELD for LSS between January 2021 and December 2023.Patients were assigned to preoperative CT/MRI registration and control groups.Data collected included the operative time,length of hospital stay,visual analog scale(VAS)scores for low back and leg pain,and the Japanese Orthopaedic Association(JOA)lumbar spine score.Differences between groups were assessed using Student’s t test.RESULTS Data from 135 patients(71 in the CT/MRI registration group,64 in the control group)were analyzed.The operative time was significantly shorter in the CT/MRI registration group(P=0.007).At 2 months postoperatively,both groups showed significant reductions in VAS leg and low back pain scores(all P<0.001)and improvements in the JOA score(both P<0.001).No complication or death occurred.Preoperatively,pain and JOA scores were similar between groups(P=0.830,P=0.470,and P=0.287,respectively).At 2 months postoperatively,patients in the CT/MRI registration group reported lower leg and low back pain levels(P<0.001 and P=0.001,respectively)and had higher JOA scores(P=0.004)than did patients in the control group.CONCLUSION Preoperative CT/MRI registration for PELD for LSS reduced the operative time and VAS pain scores at 2 months and improved JOA scores,demonstrating enhanced effectiveness and safety.展开更多
Diffusion tensor imaging is a sensitive way to reflect axonal necrosis and degeneration, glial cell regeneration and demyelination following spinal cord injury, and to display microstructure changes in the spinal cord...Diffusion tensor imaging is a sensitive way to reflect axonal necrosis and degeneration, glial cell regeneration and demyelination following spinal cord injury, and to display microstructure changes in the spinal cord in vivo. Diffusion tensor imaging technology is a sensitive method to diagnose spinal cord injury; fiber tractography visualizes the white matter fibers, and directly displays the structural integrity and resultant damage of the fiber bundle. At present, diffusion tensor imaging is restricted to brain examinations, and is rarely applied in the evaluation of spinal cord injury. This study aimed to explore the fractional anisotropy and apparent diffusion coefficient of diffusion tensor magnetic resonance imaging and the feasibility of diffusion tensor tractography in the evaluation of complete spinal cord injury in rats. The results showed that the average combined scores were obviously decreased after spinal cord transection in rats, and then began to increase over time. The fractional anisotropy scores after spinal cord transection in rats were significantly lower than those in normal rats (P 〈 0.05); the apparent diffusion coefficient was significantly increased compared with the normal group (P 〈 0.05). Following spinal cord transection, fractional anisotropy scores were negatively correlated with apparent diffusion coefficient values (r = -0.856, P 〈 0.01), and positively correlated with the average combined scores (r = 0.943, P 〈 0.01), while apparent diffusion coefficient values had a negative correlation with the average combined scores (r = -0.949, P 〈 0.01). Experimental findings suggest that, as a non-invasive examination, diffusion tensor magnetic resonance imaging can provide qualita- tive and quantitative information about spinal cord injury. The fractional anisotropy score and apparent diffusion coefficient have a good correlation with the average combined scores, which reflect functional recovery after spinal cord injury.展开更多
Some specially imaging of magnetic resonance imaging,the diffusion-weighted imaging(DWI),the diffusion tensor imaging and fractional anisotropy(FA),are useful to described,detect,and map the extent of spinal cord lesi...Some specially imaging of magnetic resonance imaging,the diffusion-weighted imaging(DWI),the diffusion tensor imaging and fractional anisotropy(FA),are useful to described,detect,and map the extent of spinal cord lesions.FA measurements may are used to predicting the outcome of patients who have spinal cord lesions.Fiber tracking enable to visualizing the integrity of white matter tracts surrounding some lesions,and this information could be used to formulating a differential diagnosis and planning biopsies or resection.In this article,we will describe the current uses for DWI and fiber tracking and speculate on others in which we believe these techniques will be useful in the future.展开更多
For now, magnetic resonance (MR) is the best noninvasive imaging modality to evaluate vertebral bone marrow thanks to its inherent soft-tissue contrast and non-ionizing nature. A daily challenging scenario for every r...For now, magnetic resonance (MR) is the best noninvasive imaging modality to evaluate vertebral bone marrow thanks to its inherent soft-tissue contrast and non-ionizing nature. A daily challenging scenario for every radiologist interpreting MR of the vertebral column is discerning the diseased from normal marrow. This requires the radiologist to be acquainted with the used MR techniques to judge the spinal marrow as well as its normal MR variants. Conventional sequences used basically to image marrow include T1W, fat-suppressed T2W and short tau inversion recovery (STIR) imaging provides gross morphological data. Interestingly, using non-routine MR sequences; such as opposed phase, diffusion weighted, MR spectroscopy and contrasted-enhanced imaging; may elucidate the nature of bone marrow heterogeneities; by inferring cellular and chemical composition; and adding new functional prospects. Recalling the normal composition of bone marrow elements and the physiologic processes of spinal marrow conversion and reconversion eases basic understanding of spinal marrow imaging. Additionally, orientation with some common variants seen during spinal marrow MR imaging as hemangiomas and bone islands is a must. Moreover, awareness of the age-associated bone marrow changes as well as changes accompanying different variations of the subject’s health state is essential for radiologists to avoid overrating normal MR marrow patterns as pathologic states and metigate unnecessary further work-up.展开更多
AIM: To investigate whether congenital lumbar spinal stenosis(CLSS) is associated with a specific degenerative changes of the lumbar spine. METHODS: The lumbar spine magnetic resonance imaging studies of 52 subjects w...AIM: To investigate whether congenital lumbar spinal stenosis(CLSS) is associated with a specific degenerative changes of the lumbar spine. METHODS: The lumbar spine magnetic resonance imaging studies of 52 subjects with CLSS and 48 control subjects were retrospectively evaluated. In each examination, the five lumbar levels were assessed for the presence or absence of circumferential or shallow annular bulges, annular tears, anterior or posterior disc herniations, epidural lipomatosis, Schmorl's nodes,spondylolisthesis, pars defects, and stress reactions of the posterior vertebral elements. RESULTS: Compared to control individuals, subjects with CLSS exhibited increased incidence of circumferential and shallow annular bulges, annular tears, discherniations and spondylolisthesis(P < 0.05). CONCLUSION: CLSS is associated with increased incidence of degenerative changes in specific osseous and soft-tissue elements of the lumbar spine.展开更多
Spinal cord injury(SCI) affects thousands of people every year in the USA, and most patients are left with some permanent paralysis. Therapeutic options are limited and only modestly affect outcome. To address this ...Spinal cord injury(SCI) affects thousands of people every year in the USA, and most patients are left with some permanent paralysis. Therapeutic options are limited and only modestly affect outcome. To address this issue, we used magnetic resonance imaging-guided focused ultrasound(MRg FUS) as a non-invasive approach to increase permeability in the blood-spinal cord barrier(BSCB). We hypothesize that localized, controlled sonoporation of the BSCB by MRg FUS will aid delivery of therapeutics to the injury. Here, we report our preliminary findings for the ability of MRg FUS to increase BSCB permeability in the thoracic spinal cord of a normal rat model. First, an excised portion of normal rat spinal column was used to characterize the acoustic field and to estimate the insertion losses that could be expected in an MRg FUS blood spinal cord barrier opening. Then, in normal rats, MRg FUS was applied in combination with intravenously administered microbubbles to the spinal cord region. Permeability of the BSCB was indicated as signal enhancement by contrast administered prior to T1-weighted magnetic resonance imaging and verified by Evans blue dye. Neurological testing using the Basso, Beattie, and Breshnahan scale and the ladder walk was normal in 8 of 10 rats tested. Two rats showed minor impairment indicating need for further refinement of parameters. No gross tissue damage was evident by histology. In this study, we have opened successfully the blood spinal cord barrier in the thoracic region of the normal rat spine using magnetic resonance-guided focused ultrasound combined with microbubbles.展开更多
Objective To assess the characteristics of magnetic resonance imaging for spinal cavernous angiomas.Methods The examinations of plain scan and contrast enhanced scan of magnetic resonance were performed in three patie...Objective To assess the characteristics of magnetic resonance imaging for spinal cavernous angiomas.Methods The examinations of plain scan and contrast enhanced scan of magnetic resonance were performed in three patients with spinal cavernous angiomas.Results The focus of two cases was located in thorax segment of the spinal cord and one in lower cervical segment.All focuses were single and the shape of spinal cord was normal or slightly thick. MRI characteristic of spinal cavernous angiomas was just like popcorn or mulberry with a jumbled gobbet signal. Low and short T 2 signal appeared around the focus. In all cases, there were no obvious contrast enhanced signal in 2 cases and one case with moderate contrast enhanced signal. The diameter of hemorrhage was smaller than that of the spinal cord.Conclusion MRI has higher sensitivity and specificity in the diagnosis of spinal cavernous angioma.展开更多
AIM To assess the correlation of lateral recess stenosis(LRS) of lumbar segments L4/5 and L5/S1 and the Oswestry Disability Index(ODI).METHODS Nine hundred and twenty-seven patients with history of low back pain were ...AIM To assess the correlation of lateral recess stenosis(LRS) of lumbar segments L4/5 and L5/S1 and the Oswestry Disability Index(ODI).METHODS Nine hundred and twenty-seven patients with history of low back pain were included in this uncontrolled study.On magnetic resonance images(MRI) the lateral recesses(LR) at lumbar levels L4/5 and L5/S1 were evaluated and each nerve root was classified into a 4-point grading scale(Grade 0-3) as normal,not deviated,deviated or compressed.Patient symptoms and disability were assessed using ODI.The Spearman's rank correlation coefficient was used for statistical analysis(P < 0.05).RESULTS Approximately half of the LR revealed stenosis(grade 1-3;52% at level L4/5 and 42% at level L5/S1) with 2.2% and 1.9% respectively reveal a nerve root compression.The ODI score ranged from 0%-91.11% with an arithmetic mean of 34.06% ± 16.89%.We observed a very weak statistically significant positive correlation between ODI and LRS at lumbar levels L4/5 and L5/S1,each bilaterally(L4/5 left:rho < 0.105,P < 0.01;L4/5 right:rho < 0.111,P < 0.01;L5/S1 left:rho 0.128,P < 0.01;L5/S1 right:rho < 0.157,P < 0.001).CONCLUSION Although MRI is the standard imaging tool for diagnosing lumbar spinal stenosis,this study showed only a weak correlation of LRS on MRI and clinical findings.This can be attributed to a number of reasons outlined in this study,underlining that imaging findings alone are not sufficient to establish a reliable diagnosis for patients with LRS.展开更多
BACKGROUND Redundant nerve roots(RNRs)of the cauda equina are often a natural evolutionary part of lumbar spinal canal stenosis secondary to degenerative processes characterized by elongated,enlarged,and tortuous nerv...BACKGROUND Redundant nerve roots(RNRs)of the cauda equina are often a natural evolutionary part of lumbar spinal canal stenosis secondary to degenerative processes characterized by elongated,enlarged,and tortuous nerve roots in the superior and/or inferior of the stenotic segment.Although magnetic resonance imaging(MRI)findings have been defined more frequently in recent years,this condition has been relatively under-recognized in radiological practice.In this study,lumbar MRI findings of RNRs of the cauda equina were evaluated in spinal stenosis patients.AIM To evaluate RNRs of the cauda equina in spinal stenosis patients.METHODS One-hundred and thirty-one patients who underwent lumbar MRI and were found to have spinal stenosis between March 2010 and February 2019 were included in the study.On axial T2-weighted images(T2WI),the cross-sectional area(CSA)of the dural sac was measured at L2-3,L3-4,L4-5,and L5-S1 levels in the axial plane.CSA levels below 100 mm^2 were considered stenosis.Elongation,expansion,and tortuosity in cauda equina fibers in the superior and/or inferior of the stenotic segment were evaluated as RNRs.The patients were divided into two groups:Those with RNRs and those without RNRs.The CSA cut-off value resulting in RNRs of cauda equina was calculated.Relative length(RL)of RNRs was calculated by dividing the length of RNRs at mid-sagittal T2WI by the height of the vertebral body superior to the stenosis level.The associations of CSA leading to RNRs with RL,disc herniation type,and spondylolisthesis were evaluated.RESULTS Fifty-five patients(42%)with spinal stenosis had RNRs of the cauda equina.The average CSA was 40.99±12.76 mm^2 in patients with RNRs of the cauda equina and 66.83±19.32 mm^2 in patients without RNRs.A significant difference was found between the two groups for CSA values(P<0.001).Using a cut-off value of 55.22 mm^2 for RNRs of the cauda equina,sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)values of 96.4%,96.1%,89.4%,and 98.7%were obtained,respectively.RL was 3.39±1.31(range:0.93-6.01).When the extension of RNRs into the superior and/or inferior of the spinal canal stenosis level was evaluated,it was superior in 54.5%,both superior and inferior in 32.8%,and inferior in 12.7%.At stenosis levels leading to RNRs of the cauda equina,29 disc herniations with soft margins and 26 with sharp margins were detected.Disc herniation type and spondylolisthesis had no significant relationship with RL or CSA of the dural sac with stenotic levels(P>0.05).As the CSA of the dural sac decreased,the incidence of RNRs observed at the superior of the stenosis level increased(P<0.001).CONCLUSION RNRs of the cauda equina are frequently observed in patients with spinal stenosis.When the CSA of the dural sac is<55 mm^2,lumbar MRIs should be carefully examined for this condition.展开更多
Magnetic resonance imaging is considered the "gold standard" technique for quantifying thigh muscle and fat cross-sectional area. We have developed a semi-automated technique to segment seven thigh compartments in p...Magnetic resonance imaging is considered the "gold standard" technique for quantifying thigh muscle and fat cross-sectional area. We have developed a semi-automated technique to segment seven thigh compartments in persons with spinal cord injury. Thigh magnetic resonance images from 18 men(18–50 years old) with traumatic motor-complete spinal cord injury were analyzed in a blinded fashion using the threshold technique. The cross-sectional area values acquired by thresholding were compared to the manual tracing technique. The percentage errors for thigh circumference were(threshold: 170.71 ± 38.67; manual: 169.45 ± 38.27 cm2) 0.74%, subcutaneous adipose tissue(threshold: 65.99±30.79; manual: 62.68 ± 30.22) 5.2%, whole muscle(threshold: 98.18 ± 20.19; manual: 98.20 ± 20.08 cm2) 0.13%, femoral bone(threshold: 6.53 ± 1.09; manual: 6.53 ± 1.09 cm2) 0.64%, bone marrow fat(threshold: 3.12 ± 1.12; manual: 3.1 ± 1.11 cm2) 0.36%, knee extensor(threshold: 43.98 ± 7.66; manual: 44.61 ± 7.81 cm2) 1.78% and % intramuscular fat(threshold: 10.45 ± 4.29; manual: 10.92 ± 8.35%) 0.47%. Collectively, these results suggest that the threshold technique provided a robust accuracy in measuring the seven main thigh compartments, while greatly reducing the analysis time.展开更多
Objective. To report the magnetic resonance imaging (MRI) findings of acute cervical central cord syndrome and to determine their correlation with the prognosis. Methods. MRI findings of 35 patients with acute central...Objective. To report the magnetic resonance imaging (MRI) findings of acute cervical central cord syndrome and to determine their correlation with the prognosis. Methods. MRI findings of 35 patients with acute central cord syndrome were studied and compared with the recovery rate of ASIA score at presentation and in follow- up. Results. MRI data demonstrated spinal cord compression for 32 patients, spinal cord swelling for 16 patients, and abnormal signal intensity within the spinal cord for 19 patients, including 14 with edema and 3 with hematoma. No significant difference of the recovery rate was noted between the patients treated nonoperatively and operatively (P >0.05). There was a significant inverse correlation between the recovery rate and the degree of spinal cord compression as shown in MRI scans (P< 0.01). The presence of hematoma in MRI scans was associated with poor prognosis, as demonstrated by a significant difference of the recovery rate (P< 0.01) among the patients with normal intensity, edema and hematoma within the spinal cord. Conclusions. MRI scans provide an efficient assistance for decision- making and accurate prognostic information regarding neurological function, and therefore should routinely be performed within the early phase of acute central cord syndrome.展开更多
AIM:To illustrate the magnetic resonce(MR) myelography features in the disease of lumbosacral nerve roots.METHODS:MR myelography using heavily T2 weighted spin-echo imaging with fat supression was performed in 75 cas...AIM:To illustrate the magnetic resonce(MR) myelography features in the disease of lumbosacral nerve roots.METHODS:MR myelography using heavily T2 weighted spin-echo imaging with fat supression was performed in 75 cases with chronic pain of waist on a Siemens Magneton Impect 1.0 TMR unit.Maximum intensity projection(MIP) was used for image reconstruction.RESULTS:The thecal maugins,nerve roots and nerve root sheaths were well demonstrated on MR myelography image.In 75 patients with chronic of waist,nerve root disease was found in 11 cases.6nerve root abnormality (8%),2perineural cyst(3%),3 neurofibroma(4%) had their own MR myelography features.CONCLUSION:MR myelography can show the morphologic and structural change of lumbosacral nerve roots.In MR myelography image,disease of lumbosacral nerve roots has a characteristic finding.MR myelography in very useful in diagnosis of nerve-root disease.展开更多
BACKGROUND Infarction of the conus medullaris is a rare form of spinal cord infarction.The first symptom is usually acute non-characteristic lumbar pain,followed by lower limb pain,saddle numbness,fecal incontinence,a...BACKGROUND Infarction of the conus medullaris is a rare form of spinal cord infarction.The first symptom is usually acute non-characteristic lumbar pain,followed by lower limb pain,saddle numbness,fecal incontinence,and sexual dysfunction.Spontaneous conus infarction with"snake-eye appearance"on magnetic resonance imaging has rarely been reported.CASE SUMMARY We report a 79-year-old male patient with spontaneous conus infarction who had acute lower extremity pain and dysuria as the first symptoms.He did not have any recent history of aortic surgery and trauma.Magnetic resonance imaging revealed a rare"snake-eye appearance."In addition,we reviewed the literature on 23 similar cases and summarized the clinical features and magnetic resonance manifestations of common diseases related to the"snake-eye sign"to explore the etiology,imaging findings,and prognosis of spontaneous conus infarction.CONCLUSION We conclude that acute onset of conus medullaris syndrome combined with"snake-eye appearance"should be strongly suspected as conus medullaris infarction caused by anterior spinal artery ischemia.This special imaging manifestation is helpful in the early diagnosis and treatment of conus infarction.展开更多
Objective To investigate the characteristics of magnetic resonance image (MRI) of spinal cord cavernous hemangioma. Methods Six cases of spinal cord cavernous heman-gioma diagnosed by MRI and confirmed by pathology we...Objective To investigate the characteristics of magnetic resonance image (MRI) of spinal cord cavernous hemangioma. Methods Six cases of spinal cord cavernous heman-gioma diagnosed by MRI and confirmed by pathology were reviewed. The characteristics of MRI were analyzed and correlated with pathological characteristics of spinal cord cavernous hemangioma. Results In 4 cases, the tumors were located in thoracic segment of the spinal cord and 2 in cervical cord. All lesions were solitary and the spinal cords were normal or a little thicker. The MRI showed that the images of focus were ball-like popcorn or mulberry with mixed signal,with short T2 signal around the focus. Under microscope, the hemangioma was composed of highly expanded blood sinusoids and its wall was thin and consisted of flat epithelial cells. There were some red blood cells in the cavity of the sinusoid and a little fibrous tissue in the diazoma between blood sinusoids. And also some fresh and old hemorrhages could be seen in the specimen. Conclusion MRI has high sensitivity and specificity in the diagnosis of spinal cavernous hemangioma.展开更多
Inflammatory demyelinating pseudotumor usually occurs in the brain and rarely occurs in the spinal cord. On imaging, inflammatory demyelinating pseudotumor appears very similar to intramedullary tumors such as gliomas...Inflammatory demyelinating pseudotumor usually occurs in the brain and rarely occurs in the spinal cord. On imaging, inflammatory demyelinating pseudotumor appears very similar to intramedullary tumors such as gliomas. It is often misdiagnosed as intramedullary tumor and surgically resected. In view of this, the clinical and magnetic resonance imaging manifestations and the pathological fea- tures of 36 cases of inflammatory demyelinating pseudotumer in the spinal cord were retrospec- tively analyzed and summarized. Most of these cases suffered from acute or subacute onset and exhibited a sensofimotor disorder. Among them, six cases were misdiagnosed as having intrame- dullary gliomas, and inflammatory demyelinating pseudotumor was only identified and pathologically confirmed after surgical resection. Lesions in the cervical and thoracic spinal cord were common. Magnetic resonance imaging revealed edema and space-occupying lesions to varying degrees at the cervical-thoracic junction, with a predominant feature of non-closed rosette-like reinforcement (open-loop sign). Pathological examination showed perivascular cuffing of predominantly dense lymphocytes, and demyelination was observed in six of the misdiagnosed cases. These re- sults suggest that tumor-like inflammatory demyelinating disease in the spinal cord is a kind of special demyelinating disease that can be categorized as inflammatory pseudotumor. These solitary lesions are easily confused with intramedullary neoplasms. Patchy or non-closed reinforcement (open-ring sign) on magnetic resonance imaging is the predominant property of inflammatory de- myelinating pseudotumor, and inflammatory cell infiltration and demyelination are additional patho- logical properties.展开更多
Based on the Wallerian degeneration in the spinal cord pathways,the changes in synaptic connections,and the spinal cord-related cellular responses that alter the cellular structure of the brain,we presumed that brain ...Based on the Wallerian degeneration in the spinal cord pathways,the changes in synaptic connections,and the spinal cord-related cellular responses that alter the cellular structure of the brain,we presumed that brain diffusion tensor imaging(DTI)parameters may change after spinal cord injury.However,the dynamic changes in DTI parameters remain unclear.We established a Beagle dog model of T10 spinal cord contusion and performed DTI of the injured spinal cord.We found dynamic changes in DTI parameters in the cerebral peduncle,posterior limb of the internal capsule,pre-and postcentral gyri of the brain within 12 weeks after spinal cord injury.We then performed immunohistochemistry to detect the expression of neurofilament heavy polypeptide(axonal marker),glial fibrillary acidic protein(glial cell marker),and NeuN(neuronal marker).We found that these pathological changes were consistent with DTI parameter changes.These findings suggest that DTI can display brain structure changes after spinal cord injury.展开更多
BACKGROUND Immunoglobulin G4-related disease(IgG4-RD)is a complex immune-mediated condition that causes fibrotic inflammation in several organs.A significant clinical feature of IgG4-RD is hypertrophic pachymeningitis...BACKGROUND Immunoglobulin G4-related disease(IgG4-RD)is a complex immune-mediated condition that causes fibrotic inflammation in several organs.A significant clinical feature of IgG4-RD is hypertrophic pachymeningitis,which manifests as inflammation of the dura mater in intracranial or spinal regions.Although IgG4-RD can affect multiple areas,the spine is a relatively rare site compared to the more frequent involvement of intracranial structures.CASE SUMMARY A 70-year-old male presented to our hospital with a two-day history of fever,altered mental status,and generalized weakness.The initial brain magnetic resonance imaging(MRI)revealed multiple small infarcts across various cerebral regions.On the second day after admission,a physical examination revealed motor weakness in both lower extremities and diminished sensation in the right lower extremity.Electromyographic evaluation revealed findings consistent with acute motor sensory neuropathy.Despite initial management with intravenous immunoglobulin for presumed Guillain-Barrésyndrome,the patient exhibited progressive worsening of motor deficits.On the 45th day of hospitalization,an enhanced MRI of the entire spine,focusing specifically on the thoracic 9 to lumbar 1 vertebral level,raised the suspicion of IgG4-related spinal pachymeningitis.Subsequently,the patient was administered oral prednisolone and participated in a comprehensive rehabilitation program that included gait training and lower extremity strengthening exercises.CONCLUSION IgG4-related spinal pachymeningitis,diagnosed on MRI,was treated with corticosteroids and a structured rehabilitation regimen,leading to significant improvement.展开更多
Many studies have shown that bio-scaffolds have important value for promoting axonal regeneration of injured spinal cord.Indeed,cell transplantation and bio-scaffold implantation are considered to be effective methods...Many studies have shown that bio-scaffolds have important value for promoting axonal regeneration of injured spinal cord.Indeed,cell transplantation and bio-scaffold implantation are considered to be effective methods for neural regeneration.This study was designed to fabricate a type of three-dimensional collagen/silk fibroin scaffold (3D-CF) with cavities that simulate the anatomy of normal spinal cord.This scaffold allows cell growth in vitro and in vivo.To observe the effects of combined transplantation of neural stem cells (NSCs) and 3D-CF on the repair of spinal cord injury.Forty Sprague-Dawley rats were divided into four groups: sham (only laminectomy was performed),spinal cord injury (transection injury of T10 spinal cord without any transplantation),3D-CF (3D scaffold was transplanted into the local injured cavity),and 3D-CF + NSCs (3D scaffold co-cultured with NSCs was transplanted into the local injured cavity.Neuroelectrophysiology,imaging,hematoxylin-eosin staining,argentaffin staining,immunofluorescence staining,and western blot assay were performed.Apart from the sham group,neurological scores were significantly higher in the 3D-CF + NSCs group compared with other groups.Moreover,latency of the 3D-CF + NSCs group was significantly reduced,while the amplitude was significantly increased in motor evoked potential tests.The results of magnetic resonance imaging and diffusion tensor imaging showed that both spinal cord continuity and the filling of injury cavity were the best in the 3D-CF + NSCs group.Moreover,regenerative axons were abundant and glial scarring was reduced in the 3D-CF + NSCs group compared with other groups.These results confirm that implantation of 3D-CF combined with NSCs can promote the repair of injured spinal cord.This study was approved by the Institutional Animal Care and Use Committee of People’s Armed Police Force Medical Center in 2017 (approval No.2017-0007.2).展开更多
An important factor in improving functional recovery from spinal cord injury using stem cells is maximizing the number of transplanted cells at the lesion site. Here, we established a contusion model of spinal cord in...An important factor in improving functional recovery from spinal cord injury using stem cells is maximizing the number of transplanted cells at the lesion site. Here, we established a contusion model of spinal cord injury by dropping a weight onto the spinal cord at T7_8. Superparamagnet- ic iron oxide-labeled bone marrow mesenchymal stem cells were transplanted into the injured spinal cord via the subarachnoid space. An outer magnetic field was used to successfully guide the labeled cells to the lesion site. Prussian blue staining showed that more bone marrow mesen- chymal stem cells reached the lesion site in these rats than in those without magnetic guidance or snperparamagnetic iron oxide labeling, and immunofluorescence revealed a greater number of complete axons at the lesion site. Moreover, the Basso, Beattie and Bresnahan (BBB) locomotor rating scale scores were the highest in rats with superparamagnetic labeling and magnetic guid- ance. Our data confirm that superparamagnetic iron oxide nanoparticles effectively label bone marrow mesenchymal stem cells and impart sufficient magnetism to respond to the external magnetic field guides. More importantly, superparamagnetic iron oxide-labeled bone marrow mesenchymal stem cells can be dynamically and non-invasively tracked in vivo using magnetic resonance imaging. Superparamagnetic iron oxide labeling of bone marrow mesenchymal stem cells coupled with magnetic guidance offers a promising avenue for the clinical treatment of spinal cord injury.展开更多
Background Despite the large scale technical innovations that have been made,a number of patients with neuromyelitis optica (NMO) are lacking NMO-IgG in both serum and cerebrospinal fluid.Longitudinally extensive sp...Background Despite the large scale technical innovations that have been made,a number of patients with neuromyelitis optica (NMO) are lacking NMO-IgG in both serum and cerebrospinal fluid.Longitudinally extensive spinal cord (LESC) lesions and linear lesions are associated with NMO.However,differences of spinal cord magnetic resonance imaging (MRI) features,including LESC lesions and linear lesions,between NMO-IgG positive and negative patients still remain unknown.The aim of the present study was to analyze the relationship between NMO-IgG status and spinal cord MRI features in NMO patients,particularly concerned about LESC lesions and linear lesions.Methods Clinical data and spinal cord MRI of 52 NMO patients were retrospectively analyzed.Eight patients were NMO-IgG negative in both serum and cerebrospinal fluid,while 44 were NMO-IgG positive.Quantitative data between the two cohorts were compared by the Student's t test or Mann-Whitney U test,the chi-square test or Fisher's exact test was used to evaluate qualitative data.Results NMO-IgG negative patients had a higher sex ratio (male/female) (P=0.014).On axial MRI,lesions in the NMO-IgG negative group were mostly located in the peripheral cord (50%),and central lesions (55%) were more common in the NMO-IgG positive group (P=-0.051).LESC lesions were common in both cohorts.None of linear lesions was found in NMO-IgG negative patients,while the NMO-IgG positive cohort had significantly more linear lesions (48%)(P=0.016).Conclusions Patients with NMO-IgG negativity may have different spinal cord lesion features compared to NMO-IgG positive patients.Diagnosis of NMO cannot be excluded even when NMO-IgG negativity and non-specific spinal lesions occur.展开更多
基金Supported by Health Commission of Shanxi Province,No.2021XM39.
文摘BACKGROUND Percutaneous endoscopic lumbar decompression(PELD)shows promise for lumbar spinal stenosis(LSS)treatment,but its use is limited by the disease's complexity and procedural challenges.AIM In this study,the effects of preoperative planning and intraoperative guidance with computed tomography(CT)/magnetic resonance imaging(MRI)registration techniques on PELD for LSS and postoperative rehabilitation outcomes were evaluated.METHODS This retrospective study was conducted with data from patients who underwent PELD for LSS between January 2021 and December 2023.Patients were assigned to preoperative CT/MRI registration and control groups.Data collected included the operative time,length of hospital stay,visual analog scale(VAS)scores for low back and leg pain,and the Japanese Orthopaedic Association(JOA)lumbar spine score.Differences between groups were assessed using Student’s t test.RESULTS Data from 135 patients(71 in the CT/MRI registration group,64 in the control group)were analyzed.The operative time was significantly shorter in the CT/MRI registration group(P=0.007).At 2 months postoperatively,both groups showed significant reductions in VAS leg and low back pain scores(all P<0.001)and improvements in the JOA score(both P<0.001).No complication or death occurred.Preoperatively,pain and JOA scores were similar between groups(P=0.830,P=0.470,and P=0.287,respectively).At 2 months postoperatively,patients in the CT/MRI registration group reported lower leg and low back pain levels(P<0.001 and P=0.001,respectively)and had higher JOA scores(P=0.004)than did patients in the control group.CONCLUSION Preoperative CT/MRI registration for PELD for LSS reduced the operative time and VAS pain scores at 2 months and improved JOA scores,demonstrating enhanced effectiveness and safety.
基金financially supported by a grant from the Shaanxi Provincial Science and Technology Research and Development Project,No.2013K12-20-08
文摘Diffusion tensor imaging is a sensitive way to reflect axonal necrosis and degeneration, glial cell regeneration and demyelination following spinal cord injury, and to display microstructure changes in the spinal cord in vivo. Diffusion tensor imaging technology is a sensitive method to diagnose spinal cord injury; fiber tractography visualizes the white matter fibers, and directly displays the structural integrity and resultant damage of the fiber bundle. At present, diffusion tensor imaging is restricted to brain examinations, and is rarely applied in the evaluation of spinal cord injury. This study aimed to explore the fractional anisotropy and apparent diffusion coefficient of diffusion tensor magnetic resonance imaging and the feasibility of diffusion tensor tractography in the evaluation of complete spinal cord injury in rats. The results showed that the average combined scores were obviously decreased after spinal cord transection in rats, and then began to increase over time. The fractional anisotropy scores after spinal cord transection in rats were significantly lower than those in normal rats (P 〈 0.05); the apparent diffusion coefficient was significantly increased compared with the normal group (P 〈 0.05). Following spinal cord transection, fractional anisotropy scores were negatively correlated with apparent diffusion coefficient values (r = -0.856, P 〈 0.01), and positively correlated with the average combined scores (r = 0.943, P 〈 0.01), while apparent diffusion coefficient values had a negative correlation with the average combined scores (r = -0.949, P 〈 0.01). Experimental findings suggest that, as a non-invasive examination, diffusion tensor magnetic resonance imaging can provide qualita- tive and quantitative information about spinal cord injury. The fractional anisotropy score and apparent diffusion coefficient have a good correlation with the average combined scores, which reflect functional recovery after spinal cord injury.
文摘Some specially imaging of magnetic resonance imaging,the diffusion-weighted imaging(DWI),the diffusion tensor imaging and fractional anisotropy(FA),are useful to described,detect,and map the extent of spinal cord lesions.FA measurements may are used to predicting the outcome of patients who have spinal cord lesions.Fiber tracking enable to visualizing the integrity of white matter tracts surrounding some lesions,and this information could be used to formulating a differential diagnosis and planning biopsies or resection.In this article,we will describe the current uses for DWI and fiber tracking and speculate on others in which we believe these techniques will be useful in the future.
文摘For now, magnetic resonance (MR) is the best noninvasive imaging modality to evaluate vertebral bone marrow thanks to its inherent soft-tissue contrast and non-ionizing nature. A daily challenging scenario for every radiologist interpreting MR of the vertebral column is discerning the diseased from normal marrow. This requires the radiologist to be acquainted with the used MR techniques to judge the spinal marrow as well as its normal MR variants. Conventional sequences used basically to image marrow include T1W, fat-suppressed T2W and short tau inversion recovery (STIR) imaging provides gross morphological data. Interestingly, using non-routine MR sequences; such as opposed phase, diffusion weighted, MR spectroscopy and contrasted-enhanced imaging; may elucidate the nature of bone marrow heterogeneities; by inferring cellular and chemical composition; and adding new functional prospects. Recalling the normal composition of bone marrow elements and the physiologic processes of spinal marrow conversion and reconversion eases basic understanding of spinal marrow imaging. Additionally, orientation with some common variants seen during spinal marrow MR imaging as hemangiomas and bone islands is a must. Moreover, awareness of the age-associated bone marrow changes as well as changes accompanying different variations of the subject’s health state is essential for radiologists to avoid overrating normal MR marrow patterns as pathologic states and metigate unnecessary further work-up.
文摘AIM: To investigate whether congenital lumbar spinal stenosis(CLSS) is associated with a specific degenerative changes of the lumbar spine. METHODS: The lumbar spine magnetic resonance imaging studies of 52 subjects with CLSS and 48 control subjects were retrospectively evaluated. In each examination, the five lumbar levels were assessed for the presence or absence of circumferential or shallow annular bulges, annular tears, anterior or posterior disc herniations, epidural lipomatosis, Schmorl's nodes,spondylolisthesis, pars defects, and stress reactions of the posterior vertebral elements. RESULTS: Compared to control individuals, subjects with CLSS exhibited increased incidence of circumferential and shallow annular bulges, annular tears, discherniations and spondylolisthesis(P < 0.05). CONCLUSION: CLSS is associated with increased incidence of degenerative changes in specific osseous and soft-tissue elements of the lumbar spine.
基金supported by the University of Utah RadiologyNeuroscience Initiative Pilot grantthe Department of Neurosurgery pilot fund
文摘Spinal cord injury(SCI) affects thousands of people every year in the USA, and most patients are left with some permanent paralysis. Therapeutic options are limited and only modestly affect outcome. To address this issue, we used magnetic resonance imaging-guided focused ultrasound(MRg FUS) as a non-invasive approach to increase permeability in the blood-spinal cord barrier(BSCB). We hypothesize that localized, controlled sonoporation of the BSCB by MRg FUS will aid delivery of therapeutics to the injury. Here, we report our preliminary findings for the ability of MRg FUS to increase BSCB permeability in the thoracic spinal cord of a normal rat model. First, an excised portion of normal rat spinal column was used to characterize the acoustic field and to estimate the insertion losses that could be expected in an MRg FUS blood spinal cord barrier opening. Then, in normal rats, MRg FUS was applied in combination with intravenously administered microbubbles to the spinal cord region. Permeability of the BSCB was indicated as signal enhancement by contrast administered prior to T1-weighted magnetic resonance imaging and verified by Evans blue dye. Neurological testing using the Basso, Beattie, and Breshnahan scale and the ladder walk was normal in 8 of 10 rats tested. Two rats showed minor impairment indicating need for further refinement of parameters. No gross tissue damage was evident by histology. In this study, we have opened successfully the blood spinal cord barrier in the thoracic region of the normal rat spine using magnetic resonance-guided focused ultrasound combined with microbubbles.
文摘Objective To assess the characteristics of magnetic resonance imaging for spinal cavernous angiomas.Methods The examinations of plain scan and contrast enhanced scan of magnetic resonance were performed in three patients with spinal cavernous angiomas.Results The focus of two cases was located in thorax segment of the spinal cord and one in lower cervical segment.All focuses were single and the shape of spinal cord was normal or slightly thick. MRI characteristic of spinal cavernous angiomas was just like popcorn or mulberry with a jumbled gobbet signal. Low and short T 2 signal appeared around the focus. In all cases, there were no obvious contrast enhanced signal in 2 cases and one case with moderate contrast enhanced signal. The diameter of hemorrhage was smaller than that of the spinal cord.Conclusion MRI has higher sensitivity and specificity in the diagnosis of spinal cavernous angioma.
文摘AIM To assess the correlation of lateral recess stenosis(LRS) of lumbar segments L4/5 and L5/S1 and the Oswestry Disability Index(ODI).METHODS Nine hundred and twenty-seven patients with history of low back pain were included in this uncontrolled study.On magnetic resonance images(MRI) the lateral recesses(LR) at lumbar levels L4/5 and L5/S1 were evaluated and each nerve root was classified into a 4-point grading scale(Grade 0-3) as normal,not deviated,deviated or compressed.Patient symptoms and disability were assessed using ODI.The Spearman's rank correlation coefficient was used for statistical analysis(P < 0.05).RESULTS Approximately half of the LR revealed stenosis(grade 1-3;52% at level L4/5 and 42% at level L5/S1) with 2.2% and 1.9% respectively reveal a nerve root compression.The ODI score ranged from 0%-91.11% with an arithmetic mean of 34.06% ± 16.89%.We observed a very weak statistically significant positive correlation between ODI and LRS at lumbar levels L4/5 and L5/S1,each bilaterally(L4/5 left:rho < 0.105,P < 0.01;L4/5 right:rho < 0.111,P < 0.01;L5/S1 left:rho 0.128,P < 0.01;L5/S1 right:rho < 0.157,P < 0.001).CONCLUSION Although MRI is the standard imaging tool for diagnosing lumbar spinal stenosis,this study showed only a weak correlation of LRS on MRI and clinical findings.This can be attributed to a number of reasons outlined in this study,underlining that imaging findings alone are not sufficient to establish a reliable diagnosis for patients with LRS.
基金This study was reviewed and approved by the Ethics Committee of the Tokat Gaziosmanpasa University Faculty of Medicine(No.19-KAEK-099).
文摘BACKGROUND Redundant nerve roots(RNRs)of the cauda equina are often a natural evolutionary part of lumbar spinal canal stenosis secondary to degenerative processes characterized by elongated,enlarged,and tortuous nerve roots in the superior and/or inferior of the stenotic segment.Although magnetic resonance imaging(MRI)findings have been defined more frequently in recent years,this condition has been relatively under-recognized in radiological practice.In this study,lumbar MRI findings of RNRs of the cauda equina were evaluated in spinal stenosis patients.AIM To evaluate RNRs of the cauda equina in spinal stenosis patients.METHODS One-hundred and thirty-one patients who underwent lumbar MRI and were found to have spinal stenosis between March 2010 and February 2019 were included in the study.On axial T2-weighted images(T2WI),the cross-sectional area(CSA)of the dural sac was measured at L2-3,L3-4,L4-5,and L5-S1 levels in the axial plane.CSA levels below 100 mm^2 were considered stenosis.Elongation,expansion,and tortuosity in cauda equina fibers in the superior and/or inferior of the stenotic segment were evaluated as RNRs.The patients were divided into two groups:Those with RNRs and those without RNRs.The CSA cut-off value resulting in RNRs of cauda equina was calculated.Relative length(RL)of RNRs was calculated by dividing the length of RNRs at mid-sagittal T2WI by the height of the vertebral body superior to the stenosis level.The associations of CSA leading to RNRs with RL,disc herniation type,and spondylolisthesis were evaluated.RESULTS Fifty-five patients(42%)with spinal stenosis had RNRs of the cauda equina.The average CSA was 40.99±12.76 mm^2 in patients with RNRs of the cauda equina and 66.83±19.32 mm^2 in patients without RNRs.A significant difference was found between the two groups for CSA values(P<0.001).Using a cut-off value of 55.22 mm^2 for RNRs of the cauda equina,sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)values of 96.4%,96.1%,89.4%,and 98.7%were obtained,respectively.RL was 3.39±1.31(range:0.93-6.01).When the extension of RNRs into the superior and/or inferior of the spinal canal stenosis level was evaluated,it was superior in 54.5%,both superior and inferior in 32.8%,and inferior in 12.7%.At stenosis levels leading to RNRs of the cauda equina,29 disc herniations with soft margins and 26 with sharp margins were detected.Disc herniation type and spondylolisthesis had no significant relationship with RL or CSA of the dural sac with stenotic levels(P>0.05).As the CSA of the dural sac decreased,the incidence of RNRs observed at the superior of the stenosis level increased(P<0.001).CONCLUSION RNRs of the cauda equina are frequently observed in patients with spinal stenosis.When the CSA of the dural sac is<55 mm^2,lumbar MRIs should be carefully examined for this condition.
基金supported by the Department of Veteran Affairs,Veteran Health Administration,Rehabilitation Research and Development Service(B7867-W)DoD-CDRMP(W81XWH-14-SCIRP-CTA)(to ASG)
文摘Magnetic resonance imaging is considered the "gold standard" technique for quantifying thigh muscle and fat cross-sectional area. We have developed a semi-automated technique to segment seven thigh compartments in persons with spinal cord injury. Thigh magnetic resonance images from 18 men(18–50 years old) with traumatic motor-complete spinal cord injury were analyzed in a blinded fashion using the threshold technique. The cross-sectional area values acquired by thresholding were compared to the manual tracing technique. The percentage errors for thigh circumference were(threshold: 170.71 ± 38.67; manual: 169.45 ± 38.27 cm2) 0.74%, subcutaneous adipose tissue(threshold: 65.99±30.79; manual: 62.68 ± 30.22) 5.2%, whole muscle(threshold: 98.18 ± 20.19; manual: 98.20 ± 20.08 cm2) 0.13%, femoral bone(threshold: 6.53 ± 1.09; manual: 6.53 ± 1.09 cm2) 0.64%, bone marrow fat(threshold: 3.12 ± 1.12; manual: 3.1 ± 1.11 cm2) 0.36%, knee extensor(threshold: 43.98 ± 7.66; manual: 44.61 ± 7.81 cm2) 1.78% and % intramuscular fat(threshold: 10.45 ± 4.29; manual: 10.92 ± 8.35%) 0.47%. Collectively, these results suggest that the threshold technique provided a robust accuracy in measuring the seven main thigh compartments, while greatly reducing the analysis time.
文摘Objective. To report the magnetic resonance imaging (MRI) findings of acute cervical central cord syndrome and to determine their correlation with the prognosis. Methods. MRI findings of 35 patients with acute central cord syndrome were studied and compared with the recovery rate of ASIA score at presentation and in follow- up. Results. MRI data demonstrated spinal cord compression for 32 patients, spinal cord swelling for 16 patients, and abnormal signal intensity within the spinal cord for 19 patients, including 14 with edema and 3 with hematoma. No significant difference of the recovery rate was noted between the patients treated nonoperatively and operatively (P >0.05). There was a significant inverse correlation between the recovery rate and the degree of spinal cord compression as shown in MRI scans (P< 0.01). The presence of hematoma in MRI scans was associated with poor prognosis, as demonstrated by a significant difference of the recovery rate (P< 0.01) among the patients with normal intensity, edema and hematoma within the spinal cord. Conclusions. MRI scans provide an efficient assistance for decision- making and accurate prognostic information regarding neurological function, and therefore should routinely be performed within the early phase of acute central cord syndrome.
文摘AIM:To illustrate the magnetic resonce(MR) myelography features in the disease of lumbosacral nerve roots.METHODS:MR myelography using heavily T2 weighted spin-echo imaging with fat supression was performed in 75 cases with chronic pain of waist on a Siemens Magneton Impect 1.0 TMR unit.Maximum intensity projection(MIP) was used for image reconstruction.RESULTS:The thecal maugins,nerve roots and nerve root sheaths were well demonstrated on MR myelography image.In 75 patients with chronic of waist,nerve root disease was found in 11 cases.6nerve root abnormality (8%),2perineural cyst(3%),3 neurofibroma(4%) had their own MR myelography features.CONCLUSION:MR myelography can show the morphologic and structural change of lumbosacral nerve roots.In MR myelography image,disease of lumbosacral nerve roots has a characteristic finding.MR myelography in very useful in diagnosis of nerve-root disease.
文摘BACKGROUND Infarction of the conus medullaris is a rare form of spinal cord infarction.The first symptom is usually acute non-characteristic lumbar pain,followed by lower limb pain,saddle numbness,fecal incontinence,and sexual dysfunction.Spontaneous conus infarction with"snake-eye appearance"on magnetic resonance imaging has rarely been reported.CASE SUMMARY We report a 79-year-old male patient with spontaneous conus infarction who had acute lower extremity pain and dysuria as the first symptoms.He did not have any recent history of aortic surgery and trauma.Magnetic resonance imaging revealed a rare"snake-eye appearance."In addition,we reviewed the literature on 23 similar cases and summarized the clinical features and magnetic resonance manifestations of common diseases related to the"snake-eye sign"to explore the etiology,imaging findings,and prognosis of spontaneous conus infarction.CONCLUSION We conclude that acute onset of conus medullaris syndrome combined with"snake-eye appearance"should be strongly suspected as conus medullaris infarction caused by anterior spinal artery ischemia.This special imaging manifestation is helpful in the early diagnosis and treatment of conus infarction.
文摘Objective To investigate the characteristics of magnetic resonance image (MRI) of spinal cord cavernous hemangioma. Methods Six cases of spinal cord cavernous heman-gioma diagnosed by MRI and confirmed by pathology were reviewed. The characteristics of MRI were analyzed and correlated with pathological characteristics of spinal cord cavernous hemangioma. Results In 4 cases, the tumors were located in thoracic segment of the spinal cord and 2 in cervical cord. All lesions were solitary and the spinal cords were normal or a little thicker. The MRI showed that the images of focus were ball-like popcorn or mulberry with mixed signal,with short T2 signal around the focus. Under microscope, the hemangioma was composed of highly expanded blood sinusoids and its wall was thin and consisted of flat epithelial cells. There were some red blood cells in the cavity of the sinusoid and a little fibrous tissue in the diazoma between blood sinusoids. And also some fresh and old hemorrhages could be seen in the specimen. Conclusion MRI has high sensitivity and specificity in the diagnosis of spinal cavernous hemangioma.
文摘Inflammatory demyelinating pseudotumor usually occurs in the brain and rarely occurs in the spinal cord. On imaging, inflammatory demyelinating pseudotumor appears very similar to intramedullary tumors such as gliomas. It is often misdiagnosed as intramedullary tumor and surgically resected. In view of this, the clinical and magnetic resonance imaging manifestations and the pathological fea- tures of 36 cases of inflammatory demyelinating pseudotumer in the spinal cord were retrospec- tively analyzed and summarized. Most of these cases suffered from acute or subacute onset and exhibited a sensofimotor disorder. Among them, six cases were misdiagnosed as having intrame- dullary gliomas, and inflammatory demyelinating pseudotumor was only identified and pathologically confirmed after surgical resection. Lesions in the cervical and thoracic spinal cord were common. Magnetic resonance imaging revealed edema and space-occupying lesions to varying degrees at the cervical-thoracic junction, with a predominant feature of non-closed rosette-like reinforcement (open-loop sign). Pathological examination showed perivascular cuffing of predominantly dense lymphocytes, and demyelination was observed in six of the misdiagnosed cases. These re- sults suggest that tumor-like inflammatory demyelinating disease in the spinal cord is a kind of special demyelinating disease that can be categorized as inflammatory pseudotumor. These solitary lesions are easily confused with intramedullary neoplasms. Patchy or non-closed reinforcement (open-ring sign) on magnetic resonance imaging is the predominant property of inflammatory de- myelinating pseudotumor, and inflammatory cell infiltration and demyelination are additional patho- logical properties.
基金supported by the National Natural Science Foundation of China, No. 82102676 (to CBL)a grant from Beijing Municipal Science & Technology Commission, No. Z171100001017076 (to JJL)+1 种基金National Key Research and Development Program, No. 2018YFF0301104 (to JJL)Research on Medical Protection Technology and Application of Induced Neural Stem Cells in the Treatment of Military Spinal Cord Injury, No. Z181100004118004 (to JL)
文摘Based on the Wallerian degeneration in the spinal cord pathways,the changes in synaptic connections,and the spinal cord-related cellular responses that alter the cellular structure of the brain,we presumed that brain diffusion tensor imaging(DTI)parameters may change after spinal cord injury.However,the dynamic changes in DTI parameters remain unclear.We established a Beagle dog model of T10 spinal cord contusion and performed DTI of the injured spinal cord.We found dynamic changes in DTI parameters in the cerebral peduncle,posterior limb of the internal capsule,pre-and postcentral gyri of the brain within 12 weeks after spinal cord injury.We then performed immunohistochemistry to detect the expression of neurofilament heavy polypeptide(axonal marker),glial fibrillary acidic protein(glial cell marker),and NeuN(neuronal marker).We found that these pathological changes were consistent with DTI parameter changes.These findings suggest that DTI can display brain structure changes after spinal cord injury.
文摘BACKGROUND Immunoglobulin G4-related disease(IgG4-RD)is a complex immune-mediated condition that causes fibrotic inflammation in several organs.A significant clinical feature of IgG4-RD is hypertrophic pachymeningitis,which manifests as inflammation of the dura mater in intracranial or spinal regions.Although IgG4-RD can affect multiple areas,the spine is a relatively rare site compared to the more frequent involvement of intracranial structures.CASE SUMMARY A 70-year-old male presented to our hospital with a two-day history of fever,altered mental status,and generalized weakness.The initial brain magnetic resonance imaging(MRI)revealed multiple small infarcts across various cerebral regions.On the second day after admission,a physical examination revealed motor weakness in both lower extremities and diminished sensation in the right lower extremity.Electromyographic evaluation revealed findings consistent with acute motor sensory neuropathy.Despite initial management with intravenous immunoglobulin for presumed Guillain-Barrésyndrome,the patient exhibited progressive worsening of motor deficits.On the 45th day of hospitalization,an enhanced MRI of the entire spine,focusing specifically on the thoracic 9 to lumbar 1 vertebral level,raised the suspicion of IgG4-related spinal pachymeningitis.Subsequently,the patient was administered oral prednisolone and participated in a comprehensive rehabilitation program that included gait training and lower extremity strengthening exercises.CONCLUSION IgG4-related spinal pachymeningitis,diagnosed on MRI,was treated with corticosteroids and a structured rehabilitation regimen,leading to significant improvement.
基金supported by the National Natural Science Foundation of China,No.11672332(to XYC)the National Key Research and Development Plan of China,No.2016YFC1101500(to SZ)
文摘Many studies have shown that bio-scaffolds have important value for promoting axonal regeneration of injured spinal cord.Indeed,cell transplantation and bio-scaffold implantation are considered to be effective methods for neural regeneration.This study was designed to fabricate a type of three-dimensional collagen/silk fibroin scaffold (3D-CF) with cavities that simulate the anatomy of normal spinal cord.This scaffold allows cell growth in vitro and in vivo.To observe the effects of combined transplantation of neural stem cells (NSCs) and 3D-CF on the repair of spinal cord injury.Forty Sprague-Dawley rats were divided into four groups: sham (only laminectomy was performed),spinal cord injury (transection injury of T10 spinal cord without any transplantation),3D-CF (3D scaffold was transplanted into the local injured cavity),and 3D-CF + NSCs (3D scaffold co-cultured with NSCs was transplanted into the local injured cavity.Neuroelectrophysiology,imaging,hematoxylin-eosin staining,argentaffin staining,immunofluorescence staining,and western blot assay were performed.Apart from the sham group,neurological scores were significantly higher in the 3D-CF + NSCs group compared with other groups.Moreover,latency of the 3D-CF + NSCs group was significantly reduced,while the amplitude was significantly increased in motor evoked potential tests.The results of magnetic resonance imaging and diffusion tensor imaging showed that both spinal cord continuity and the filling of injury cavity were the best in the 3D-CF + NSCs group.Moreover,regenerative axons were abundant and glial scarring was reduced in the 3D-CF + NSCs group compared with other groups.These results confirm that implantation of 3D-CF combined with NSCs can promote the repair of injured spinal cord.This study was approved by the Institutional Animal Care and Use Committee of People’s Armed Police Force Medical Center in 2017 (approval No.2017-0007.2).
基金supported by the National Natural Science Foundation of China,No.81371628the Postdoctoral Science Foundation of China,No.2014T70233,2013M541206the Innovation Foundation of Shanxi Medical University First Hospital of China
文摘An important factor in improving functional recovery from spinal cord injury using stem cells is maximizing the number of transplanted cells at the lesion site. Here, we established a contusion model of spinal cord injury by dropping a weight onto the spinal cord at T7_8. Superparamagnet- ic iron oxide-labeled bone marrow mesenchymal stem cells were transplanted into the injured spinal cord via the subarachnoid space. An outer magnetic field was used to successfully guide the labeled cells to the lesion site. Prussian blue staining showed that more bone marrow mesen- chymal stem cells reached the lesion site in these rats than in those without magnetic guidance or snperparamagnetic iron oxide labeling, and immunofluorescence revealed a greater number of complete axons at the lesion site. Moreover, the Basso, Beattie and Bresnahan (BBB) locomotor rating scale scores were the highest in rats with superparamagnetic labeling and magnetic guid- ance. Our data confirm that superparamagnetic iron oxide nanoparticles effectively label bone marrow mesenchymal stem cells and impart sufficient magnetism to respond to the external magnetic field guides. More importantly, superparamagnetic iron oxide-labeled bone marrow mesenchymal stem cells can be dynamically and non-invasively tracked in vivo using magnetic resonance imaging. Superparamagnetic iron oxide labeling of bone marrow mesenchymal stem cells coupled with magnetic guidance offers a promising avenue for the clinical treatment of spinal cord injury.
文摘Background Despite the large scale technical innovations that have been made,a number of patients with neuromyelitis optica (NMO) are lacking NMO-IgG in both serum and cerebrospinal fluid.Longitudinally extensive spinal cord (LESC) lesions and linear lesions are associated with NMO.However,differences of spinal cord magnetic resonance imaging (MRI) features,including LESC lesions and linear lesions,between NMO-IgG positive and negative patients still remain unknown.The aim of the present study was to analyze the relationship between NMO-IgG status and spinal cord MRI features in NMO patients,particularly concerned about LESC lesions and linear lesions.Methods Clinical data and spinal cord MRI of 52 NMO patients were retrospectively analyzed.Eight patients were NMO-IgG negative in both serum and cerebrospinal fluid,while 44 were NMO-IgG positive.Quantitative data between the two cohorts were compared by the Student's t test or Mann-Whitney U test,the chi-square test or Fisher's exact test was used to evaluate qualitative data.Results NMO-IgG negative patients had a higher sex ratio (male/female) (P=0.014).On axial MRI,lesions in the NMO-IgG negative group were mostly located in the peripheral cord (50%),and central lesions (55%) were more common in the NMO-IgG positive group (P=-0.051).LESC lesions were common in both cohorts.None of linear lesions was found in NMO-IgG negative patients,while the NMO-IgG positive cohort had significantly more linear lesions (48%)(P=0.016).Conclusions Patients with NMO-IgG negativity may have different spinal cord lesion features compared to NMO-IgG positive patients.Diagnosis of NMO cannot be excluded even when NMO-IgG negativity and non-specific spinal lesions occur.