A University of Maryland study suggests that diffusion tensor imaging may provide emergency room physicians with valuable information to assess the extent of injuries to the cervical spine.

Researchers have had reasonable success with diffusion-weighted MR imaging and DTI in spinal injury experiments in animals. Radiologists Dr. Sendhil Kumar Cheran and colleagues retrospectively evaluated changes in 50 human patients with blunt trauma neck injury using DTI to measure apparent diffusion coefficient and fractional anisotropy. Results were compared with DTI performed on 11 healthy volunteers.

MRI was performed on the trauma patients when emergency CT failed to explain a neurological deficit localized to the cervical spine, neck pain, or tenderness. DTI data were also acquired when MRI was performed to assess the extent of ligament injury after a cervical spine fracture diagnosed with emergency CT.

Cheran found that the ADC values of all patients with MR signal abnormalities of cord contusion were significantly lower than those from healthy controls.

In patients with positive CT findings of acute cervical trauma but no MRI cord signal abnormality, ADC was significantly decreased in the upper and middle cervical cord sections compared with the controls, with nearly significant decrease in the lower cervical spinal cord.

Mean FA values for all cervical spine trauma patients were significantly decreased in the middle and lower cervical cord compared with the ontrol subjects.

These findings led Cheran to conclude that ADC and FA are potential markers of the presence and severity of cervical spine cord injury. With further inquiry, the measures may prove particularly useful for evaluating trauma patients with clinical symptoms who lack conventional MRI findings of cord contusion.