Traumatic spinal cord injury (tSCI) causes an immediate loss of neurological function, and the prediction of recovery is difficult in the acute phase. In this study, we used contrast-enhanced ultrasound imaging to quantify intraspinal vascular disruption acutely after tSCI. In a rodent thoracic tSCI model, contrast-enhanced ultrasound revealed a perfusion area deficit that was positively correlated with injury severity and negatively correlated with hindlimb locomotor function at 8 weeks after injury. The spinal perfusion index was calculated by normalizing the contrast inflow at the injury center to the contrast inflow in the injury periphery. The spinal perfusion index decreased with increasing injury severity and positively correlated with hindlimb locomotor function at 8 weeks after injury. The feasibility of intraoperative contrast-enhanced ultrasound imaging was further tested in a cohort of 27 patients with acute tSCI of varying severity and including both motor-complete and motor-incomplete tSCIs. Both the perfusion area deficit and spinal perfusion index were different between motor-complete and motor-incomplete patients. Moreover, the perfusion area deficit and spinal perfusion index correlated with the injury severity at intake and exhibited a correlation with extent of functional recovery at 6 months. Our data suggest that intraoperative contrast-enhanced, ultrasound-derived metrics are correlated with injury severity and chronic functional outcome after tSCI. Larger clinical studies are required to better assess the reliability of the proposed contrast-enhanced ultrasound biomarkers and their prognostic capacity.

中文翻译：

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急性创伤性脊髓损伤后的灌注显像指标与大鼠和人类损伤严重程度相关


创伤性脊髓损伤 （tSCI） 会导致神经功能立即丧失，并且在急性期很难预测恢复。在这项研究中，我们使用对比增强超声成像来量化 tSCI 后急性椎管内血管破裂。在啮齿动物胸部 tSCI 模型中，对比增强超声显示灌注面积缺损，与受伤后 8 周的损伤严重程度呈正相关，与后肢运动功能呈负相关。通过将损伤中心的造影剂流入归一化为损伤周边的造影剂流入来计算脊髓灌注指数。脊髓灌注指数随着损伤严重程度的增加而降低，与损伤后 8 周后肢运动功能呈正相关。在 27 例不同严重程度的急性 tSCI 患者队列中进一步测试了术中对比增强超声成像的可行性，包括运动完全性和运动不完全性 tSCI。运动完全和运动不完全患者的灌注面积不足和脊髓灌注指数均存在差异。此外，灌注面积不足和脊髓灌注指数与摄入时的损伤严重程度相关，并与 6 个月时功能恢复的程度呈相关性。我们的数据表明，术中对比增强的超声衍生指标与 tSCI 后的损伤严重程度和慢性功能结果相关。需要更大规模的临床研究来更好地评估所提出的对比增强超声生物标志物的可靠性及其预后能力。