{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T12:06:49Z","timestamp":1793448409891,"version":"4.5.0"},"reference-count":34,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,1,9]],"date-time":"2020-01-09T00:00:00Z","timestamp":1578528000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:p>This prospective longitudinal study compares the ability of conventional and diffusion tensor imaging (DTI) parameters made at the cervical spinal cord injury (CSCI) site to predict long-term neurological and functional outcomes. Twenty patients with CSCI, with follow-up at 6 or 12 months, and 15 control volunteers were included. Conventional magnetic resonance imaging (MRI) and DTI parameters were measured on admission and follow-up studies. Stepwise regression analysis was performed to find relevant parameters (normalized DTI values, conventional MRI measurements, hemorrhagic contusion [HC] or non-HC [NHC]) that correlated with three primary outcome measures: patient International Standards for Neurological Classification of Spinal Cord Injury total motor score (ISNCSCI-TMS), ability to walk, and expected recovery of upper limb motor scores (ER-ULMS) at 6 or 12 months.<\/jats:p>\n                  <jats:p>\n                    Univariate analysis showed HC (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.0001 to 0.0098), lesion length on follow-up MRI (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.0001 to 0.019), mean diffusivity (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.01 to 0.045), and axial diffusivity (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.004 to 0.023) predicted all three primary outcomes. Conspicuity of HC was significantly better on axial susceptibility-weighted imaging (SWI) compared with T2* images (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.0009). A negative correlation existed between HC volumes on sagittal SWI images and follow-up ISNCSCI-TMS (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.02). The regression model identified NHC as the best predictor of the ability to walk (sensitivity\u2009=\u200988.9%; specificity\u2009=\u2009100%; positive predictive value\u2009=\u2009100%; negative predictive value\u2009=\u200991%;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.0001) and lesion length on follow-up MRI as the best predictor of ER-ULMS (\u03b2 coefficient\u2009=\u20090.12, standard error [SE]\u2009=\u20090.07; R\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u20090.64;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.0002). Finally, NHC (\u03b2 coefficient\u2009=\u200924.2, SE\u2009=\u20093.7;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.0001) and lesion length on initial MRI (\u03b2 coefficient\u2009=\u20090.78, SE\u2009=\u20090.2;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.002) were the best predictors of ISNCSCI-TMS (R\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u20090.83;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.0001). Our study demonstrates HC and follow-up lesion length are potential neuroimaging biomarkers in predicting long-term neurological and functional outcome following blunt CSCI.\n                  <\/jats:p>","DOI":"10.1089\/neu.2019.6394","type":"journal-article","created":{"date-parts":[[2019,6,13]],"date-time":"2019-06-13T07:41:20Z","timestamp":1560411680000},"page":"458-465","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["Comparison of Acute Diffusion Tensor Imaging and Conventional Magnetic Resonance Parameters in Predicting Long-Term Outcome after Blunt Cervical Spinal Cord Injury"],"prefix":"10.1177","volume":"37","author":[{"given":"Kathirkamanathan","family":"Shanmuganathan","sequence":"first","affiliation":[{"name":"Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiachen","family":"Zhuo","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uttam K.","family":"Bodanapally","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudini","family":"Kuladeep","sequence":"additional","affiliation":[{"name":"Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bizhan","family":"Aarabi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Services, University of Maryland School of Medicine, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catriona","family":"Miller","sequence":"additional","affiliation":[{"name":"Aeromedical Research Department, U.S. Air Force School of Aerospace Medicine, Center for the Sustainment of Trauma and Readiness Skills, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rao P.","family":"Gullapallie","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Menakar","sequence":"additional","affiliation":[{"name":"R. 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