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Research ArticlePediatric Neuroimaging
Open Access

Diffusion Tensor Imaging of the Normal Cervical and Thoracic Pediatric Spinal Cord

S. Saksena, D.M. Middleton, L. Krisa, P. Shah, S.H. Faro, R. Sinko, J. Gaughan, J. Finsterbusch, M.J. Mulcahey and F.B. Mohamed
American Journal of Neuroradiology November 2016, 37 (11) 2150-2157; DOI: https://doi.org/10.3174/ajnr.A4883
S. Saksena
aFrom the Departments of Radiology (S.S., F.B.M.)
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D.M. Middleton
cDepartment of Radiology (D.M.M., P.S., S.H.F.), Temple University, Philadelphia, Pennsylvania
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L. Krisa
bOccupational Therapy (L.K., R.S., M.J.M.), Thomas Jefferson University, Philadelphia, Pennsylvania
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P. Shah
cDepartment of Radiology (D.M.M., P.S., S.H.F.), Temple University, Philadelphia, Pennsylvania
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S.H. Faro
cDepartment of Radiology (D.M.M., P.S., S.H.F.), Temple University, Philadelphia, Pennsylvania
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R. Sinko
bOccupational Therapy (L.K., R.S., M.J.M.), Thomas Jefferson University, Philadelphia, Pennsylvania
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J. Gaughan
dBiostatistics Consulting Center (J.G.), Temple University School of Medicine, Philadelphia, Pennsylvania
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J. Finsterbusch
eDepartment of Systems Neuroscience (J.F.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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M.J. Mulcahey
bOccupational Therapy (L.K., R.S., M.J.M.), Thomas Jefferson University, Philadelphia, Pennsylvania
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F.B. Mohamed
aFrom the Departments of Radiology (S.S., F.B.M.)
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    Fig 1.

    Localization image from which the axial cervical (A) and thoracic (B) SC sections are prescribed. The inner solid white rectangular line represents the inner FOV, which was oversampled (dotted white line) to avoid aliasing.

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    Fig 2.

    Axial FA color maps of each intervertebral disc level and within the mid-vertebral body level along the entire cervical and thoracic SC in a typically developing subject (C1 to T12–L1 level). An example of GM at the mid-C5 level is shown with an arrow, and WM, with an arrowhead.

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    Fig 3.

    Sagittal reconstruction of FA color maps of 2 overlapping slabs of the same subject as shown in Fig 2. A, The cervical and upper thoracic regions (C1, arrow, to T5, arrowhead). B, The upper thoracic-through-conus regions (T4, arrow, to L1, arrowhead).

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    Fig 4.

    Linear fit plots showing the relationship among FA (A), MD (B), AD (C), and RD (D) and age along the cervical and thoracic SC (C1 to mid-L1) in typically developing pediatric subjects.

Tables

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    Table 1:

    Means of FA, MD, AD, and RD along the cervical and thoracic SC according to age groups

    DTI ParametersAge Groups (yr)P Values
    6–1112–16
    FA0.54 ± 0.090.58 ± 0.10.0193
    MD1.14 ± 0.260.91 ± 0.21<.0001
    AD1.88 ± 0.381.58 ± 0.38<.0001
    RD0.77 ± 0.230.58 ± 0.17<.0001
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    Table 2:

    Means of FA, MD, AD, and RD according to different levels of the cervical and thoracic SC

    DTI ParametersCord Divisions
    CUPCMIDCLOWTUPTMIDTLOW
    FAa0.60 ± 0.080.59 ± 0.070.54 ± 0.080.53 ± 0.090.60 ± 0.100.49 ± 0.09
    MDb1.06 ± 0.201.08 ± 0.151.15 ± 0.240.98 ± 0.321.05 ± 0.260.93 ± 0.27
    ADc1.85 ± 0.301.90 ± 0.201.89 ± 0.331.58 ± 0.501.83 ± 0.351.45 ± 0.41
    RDd0.66 ± 0.180.67 ± 0.150.78 ± 0.230.67 ± 0.260.66 ± 0.240.66 ± 0.23
    • Note:—CUP indicates upper cervical cord; CMID, middle cervical cord; CLOW, lower cervical cord, TUP, upper thoracic cord; TMID, middle thoracic cord; TLOW, lower thoracic cord.

    • ↵a FA = CUP vs CMID: P = .3732; CUP vs CLOW: P < .0001; CMID vs CLOW: P <. 0001; TUP vs TMID: P < .0001; TUP vs TLOW: P < .0001; TMID vs TLOW: P < .0001.

    • ↵b MD = CUP vs CMID: P = .1357; CUP vs CLOW: P < .0001; CMID vs CLOW: P = .0265; TUP vs TMID: P < .0001; TUP vs TLOW: P = .2665; TMID vs TLOW: P < .0001.

    • ↵c AD = CUP vs TUP: P < .0001; CUP vs TLOW: P <. 0001; CUP vs TMID: P = .1485; CMID vs TUP: P <. 0001; CMID vs TMID: P = .0033; CMID vs TLOW: P < .0001; CLOW vs TUP: P < .0001; CLOW vs TMID: P = .0158; CLOW vs TLOW: P < .0001.

    • ↵d RD = CUP vs TUP: P = .2707; CUP vs TLOW: P = .9320; CUP vs TMID: P = .1044; CMID vs TUP: P = .0198; CMID vs TMID: P = .0048; CMID vs TLOW: P = .1774; CLOW vs TUP: P < .0001; CLOW vs TMID: P <. 0001; CLOW vs TLOW: P < .0001.

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    Table 3:

    Test-retest repeatability for each DTI parameter per the cervical and thoracic SC

    DTI ParametersLevelICC (95% CI)
    FACervical0.86 (0.86–0.70)
    Thoracic0.85 (0.85–0.67)
    MDCervical0.91 (0.91–0.79)
    Thoracic0.89 (0.90–0.73)
    ADCervical0.91 (0.91–0.79)
    Thoracic0.80 (0.83–0.55)
    RDCervical0.90 (0.90–0.77)
    Thoracic0.92 (0.93–0.82)
    • Note:—ICC indicates intraclass correlation coefficient.

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American Journal of Neuroradiology: 37 (11)
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S. Saksena, D.M. Middleton, L. Krisa, P. Shah, S.H. Faro, R. Sinko, J. Gaughan, J. Finsterbusch, M.J. Mulcahey, F.B. Mohamed
Diffusion Tensor Imaging of the Normal Cervical and Thoracic Pediatric Spinal Cord
American Journal of Neuroradiology Nov 2016, 37 (11) 2150-2157; DOI: 10.3174/ajnr.A4883

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Diffusion Tensor Imaging of the Normal Cervical and Thoracic Pediatric Spinal Cord
S. Saksena, D.M. Middleton, L. Krisa, P. Shah, S.H. Faro, R. Sinko, J. Gaughan, J. Finsterbusch, M.J. Mulcahey, F.B. Mohamed
American Journal of Neuroradiology Nov 2016, 37 (11) 2150-2157; DOI: 10.3174/ajnr.A4883
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