title: Manganese-enhanced MRI Offers Correlation with Severity of Spinal Cord Injury in Experimental Models.
abstract: BACKGROUND
  Spinal cord injuries (SCI) are clinically challenging, because neural regeneration after cord damage is unknown. In SCI animal models, regeneration is evaluated histologically, requiring animal sacrifice. Noninvasive techniques are needed to detect longitudinal SCI changes.
  
  
  OBJECTIVE
  To compare manganese-enhanced magnetic resonance imaging (MRI [MEMRI]) in hemisection and transection of SCI rat models with diffusion tensor imaging (DTI) and histology.
  
  
  METHODS
  Rats underwent T9 spinal cord transection (n=6), hemisection (n=6), or laminectomy without SCI (controls, n=6). One-half of each group received lateral ventricle MnCl2injections 24 hours later. Conventional DTI or T1-weighted MRI was performed 84 hours post-surgery. MEMRI signal intensity ratio above and below the SCI level was calculated. Fractional anisotropy (FA) measurements were taken 1 cm rostral to the SCI. The percentage of FA change was calculated 10 mm rostral to the SCI epicenter, between FA at the dorsal column lesion normalized to a lateral area without FA change. Myelin load (percentage difference) among groups was analyzed by histology.
  
  
  RESULTS
  In transection and hemisection groups, mean MEMRI ratios were 0.62 and 0.87, respectively,versus0.99 in controls (P<0.001 and P<0.001, respectively); mean FA decreases were 67.5% and 40.1%, respectively, compared with a 6.1% increase in controls (P=0.002 and P=0.019, respectively). Mean myelin load decreased by 38.8% (transection) and 51.8% (hemisection) compared to controls (99.1%) (P<0.001 and P<0.001, respectively). Pearson's correlation coefficients were -0.94 for MEMRI ratio and FA changes and 0.87 for MEMRI and myelin load.
  
  
  CONCLUSIONS
  MEMERI results correlated to SCI severity measured by FA and myelin load. MEMRI is a useful noninvasive tool to assess neuronal damage after SCI.
authors.affiliation: Departments of Neurosurgery, Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix, Arizona,USA.
authors.forename: Nikolay L
authors.initials: NL
authors.lastname: Martirosyan
authors.affiliation: Center for Preclinical Imaging, Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix, Arizona, USA.
authors.forename: Gregory H
authors.initials: GH
authors.lastname: Turner
authors.affiliation: Department of Anatomy, Midwestern University Glendale, Arizona, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Kaufman
authors.affiliation: Departments of Neurosurgery, Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix, Arizona,USA.
authors.forename: Arpan A
authors.initials: AA
authors.lastname: Patel
authors.affiliation: Departments of Neurosurgery, Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix, Arizona,USA ; Irkutsk Scientific Center of Surgery and Traumatology, Irkutsk, Russia.
authors.forename: Evgenii
authors.initials: E
authors.lastname: Belykh
authors.affiliation: Departments of Neurosurgery, Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix, Arizona,USA.
authors.forename: M Yashar S
authors.initials: MY
authors.lastname: Kalani
authors.affiliation: Departments of Neurosurgery, Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix, Arizona,USA.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Theodore
authors.affiliation: Departments of Neurosurgery, Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix, Arizona,USA.
authors.forename: Mark C
authors.initials: MC
authors.lastname: Preul
keywords: Diffusion tensor imaging; Fractional anisotropy; Magnetic resonance imaging; Manganese; Manganese-enhanced MRI; Spinal cord; Spinal cord injury