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Spinal cord microstructure integrating phase-sensitive inversion recovery and diffusional kurtosis imaging

  • Spinal Neuroradiology
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Abstract

Purpose

The aim of this prospective study was to determine the feasibility in terms of repeatability and reproducibility of diffusional kurtosis imaging (DKI) for microstructural assessment of the normal cervical spinal cord (cSC) using a phase-sensitive inversion recovery (PSIR) sequence as the anatomical reference for accurately defining white-matter (WM) and gray-matter (GM) regions of interests (ROIs).

Methods

Thirteen young healthy subjects were enrolled to undergo DKI and PSIR sequences in the cSC. The repeatability and reproducibility of kurtosis metrics and fractional anisotropy (FA) were calculated in GM, WM, and cerebral-spinal-fluid (CSF) ROIs drawn by two independent readers on PSIR images of three different levels (C1–C4). The presence of statistically significant differences in DKI metrics for levels, ROIs (GM, WM, and CSF) repeatability, reproducibility, and inter-reader agreement was evaluated.

Results

Intra-class correlation coefficients between the two readers ranged from good to excellent (0.75 to 0.90). The inferior level consistently had the highest concordance. The lower values of scan–rescan variability for all DKI parameters were found for the inferior level. Statistically significant differences in kurtosis values were not found in the lateral white-matter bundles of the spinal cord.

Conclusion

The integration of DKI and PSIR sequences in a clinical MR acquisition to explore the regional microstructure of the cSC in healthy subjects is feasible, and the results obtainable are reproducible. Further investigation will be required to verify the possibility to translate this method to a clinical setting to study patients with SC involvement especially in the absence of MRI abnormalities on standard sequences.

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Authors and Affiliations

  1. Department of Neuroscience, Imaging and Clinical Sciences, University “G. “D’Annunzio”, Chieti, Italy

    V. Panara, R Navarra, A. R. Cotroneo, A. Uncini & M. Caulo

  2. ITAB Institute of Advanced Biomedical Technologies, University “G. d’Annunzio”, Via Luigi Polacchi, 11 66100, Chieti, Italy

    V. Panara, R Navarra, P. A. Mattei, E. Piccirilli & M. Caulo

  3. Department of Medicine and Science of Aging, Ophthalmology Clinic, University “G. d’Annunzio”, Chieti, Italy

    P. A. Mattei

  4. Department of Neurology, University of California, San Francisco, San Francisco, CA, USA

    N. Papinutto & R. G. Henry

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  1. V. Panara
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Correspondence to V. Panara.

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Funding

VP was funded by a grant from the Italian Association of Neuroradiology - AINR.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Panara, V., Navarra, R., Mattei, P.A. et al. Spinal cord microstructure integrating phase-sensitive inversion recovery and diffusional kurtosis imaging. Neuroradiology 59, 819–827 (2017). https://doi.org/10.1007/s00234-017-1864-5

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  • DOI: https://doi.org/10.1007/s00234-017-1864-5

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