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Thread: what level is your injury really at?

  1. #1

    what level is your injury really at?

    I hope everyone can have access to diagnostic break-throughs that have been available for years. What level are your stem cells going to be placed? See attatchment: Love Patti

  2. #2
    Quote Originally Posted by mckeownp View Post
    I hope everyone can have access to diagnostic break-throughs that have been available for years. What level are your stem cells going to be placed? See attatchment: Love Patti
    You are correct. DTI (diffusion tensor imaging) is one of the most important breakthroughs in images of the spinal cord. The reason is because DTI shows oriented structures as having brighter signals. Because white matter has many oriented fibers (axons), it shows up as bright white MRI. Where the lesion is, there is less white matter and more disorganized cells. Thus, DTI illustrates clearly the white matter and the injury site. We will be using DTI in ChinaSCINet for determining the best place for cell injection.

    Wise.

  3. #3
    Quote Originally Posted by Wise Young View Post
    You are correct. DTI (diffusion tensor imaging) is one of the most important breakthroughs in images of the spinal cord. The reason is because DTI shows oriented structures as having brighter signals. Because white matter has many oriented fibers (axons), it shows up as bright white MRI. Where the lesion is, there is less white matter and more disorganized cells. Thus, DTI illustrates clearly the white matter and the injury site. We will be using DTI in ChinaSCINet for determining the best place for cell injection.

    Wise.
    Is DTI imaging available in the US? If yes, where?

  4. #4

    stem cell placement

    Quote Originally Posted by 6 Shooter View Post
    Is DTI imaging available in the US? If yes, where?
    The technology is not new. I've been imaging diffusion MRI of the brain since 2007. The cervical and less so the lumbar spine is more diagnostic than the thoracic. Heart motion is the culprit. I will repost with any current research facility. I know this is important but clinicians do not order this exam on a regular basis.

  5. #5
    I wonder how this imaging system works on peripheral nerves?

    Diagnosing avulsed (torn out from from spinal cord) nerves was, and still continues to be, very difficult. It seems exploratory surgery is the only real & accurate diagnostic.

  6. #6
    Quote Originally Posted by cljanney View Post
    I wonder how this imaging system works on peripheral nerves?

    Diagnosing avulsed (torn out from from spinal cord) nerves was, and still continues to be, very difficult. It seems exploratory surgery is the only real & accurate diagnostic.
    cljanney, diffusion tensor imaging (DTI) has become a very valuable tool for assessing peripheral nerve injury. Peripheral nerves appear to be bright on DTI and you can see where they have been injured, avulsed, or even demyelinated. When applied with a 3.0T MRI magnet, one can get very high resolution images that provide information that cannot be obtained by any other method.

    Last summer, John McDonald showed a DTI of Pat Rummerfield's spinal cord, showing a tiny strand of axons that crossed the injury site. As you may know, Pat is walking (in fact running in ultramarathon and a ironman triathlete).

    Wise.

  7. #7
    Senior Member Scorpion's Avatar
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    Quote Originally Posted by Wise Young View Post
    Last summer, John McDonald showed a DTI of Pat Rummerfield's spinal cord, showing a tiny strand of axons that crossed the injury site. As you may know, Pat is walking (in fact running in ultramarathon and a ironman triathlete).
    So this gives more credence to the assertion that even just 10% of the cord's axons need to be intact in order to have major recovery?

  8. #8
    Quote Originally Posted by Wise Young View Post
    cljanney, diffusion tensor imaging (DTI) has become a very valuable tool for assessing peripheral nerve injury. Peripheral nerves appear to be bright on DTI and you can see where they have been injured, avulsed, or even demyelinated. When applied with a 3.0T MRI magnet, one can get very high resolution images that provide information that cannot be obtained by any other method.

    Last summer, John McDonald showed a DTI of Pat Rummerfield's spinal cord, showing a tiny strand of axons that crossed the injury site. As you may know, Pat is walking (in fact running in ultramarathon and a ironman triathlete).

    Wise.

    Thank you Wise!

    I'll spread the news about this in the Brachial Plexus Injury community. Myelograms have been one of the best diagnostics for nerve root avulsions, and they are still not all that perfect (and a bit archaic). DTI sound much more promising! I'm looking forward to reading more about it.

    Thanks,
    Christopher

  9. #9
    Okay, I had one of these done about 3 years ago. MRN & DTI are related imaging technologies invented by the same man, Dr. Aaron Filler.

    Dr. Filler, the principal founder of this technology, is on of the specialists I've seen and had me get an MRN (Neurography) to determine if I had any nerve compression, scar tissue, or neuromas on my existing intact nerves that were causing my pain. The tests came out inconclusive unfortunately, and since he doesn't have any agreements with any health insurance companies, I couldn't afford to go in for another exploratory surgery.

    I was very excited to get this imaging done, because it's a disconcerting thing when you've had mass quantities and types of diagnostics, but still never get a clear "picture" of the exact damage done.

    When I had my first surgery at the Mayo Clinic back in 2003, my neurosurgeon poo-pooed MRNs, saying that they hadn't been proven yet. But I knew that one of other leading specialists in the US for Brachial Plexus Injuries at Johns Hopkins was using this type of Diagnostic. It is my understanding that the Mayo Clinic now uses it as well.

    http://en.wikipedia.org/wiki/Neurography
    (MRN Neurography is) a related technique for imaging neural tracts in the brain and spinal cord is called magnetic resonance tractography or diffusion tensor imaging.
    http://en.wikipedia.org/wiki/Diffusi...tensor_imaging

    http://www.neurography.com/
    http://www.nervemed.com/aboutaf.html


    http://precedings.nature.com/documents/1932/version/1

    MR Neurography and Diffusion Tensor Imaging: Origin, History and Impact


    Aaron G. Filler
    Institute for Nerve Medicine

    Posted 24 June 2008

    Objective – Methods were invented that made it possible to image peripheral nerves in the body and to image neural tracts in the brain. Over a 15 year period, these techniques – MR Neurography and Diffusion Tensor Imaging – were then deployed in the clinical and research community and applied to about 50,000 patients. Within this group, about 5,000 patients having MR Neurography were carefully tracked on a prospective basis.

    Method – In the study group a uniform imaging methodology was applied and all images were reviewed and registered by referral source, clinical indication, efficacy of imaging and quality. Various classes of image findings were identified and subjected to a variety of small targeted prospective outcome studies. Those findings demonstrated to be clinically significant were then tracked in the larger clinical volume data set.

    Results – MR Neurography demonstrates mechanical distortion of nerves, hyperintensity consistent with nerve irritation, nerve swelling, discontinuity, relations of nerves to masses, and image features revealing distortion of nerve at entrapment points. These findings are often clinically relevant and warrant full consideration in the diagnostic process. They result in specific pathologic diagnoses that are comparable to electrodiagnostic testing in clinical efficacy.

    Conclusions – MR Neurography and DTI neural tract imaging have been validated as indispensable clinical diagnostic methods that provide reliable anatomical pathological information. There is no alternative diagnostic method in many situations. With the elapse of 15 years, tens of thousands of imaging studies, and hundreds of publications, these methods should no longer be considered experimental.
    Last edited by cljanney; 02-13-2009 at 04:36 PM.

  10. #10
    Senior Member Imight's Avatar
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    I've been asking how I can view my spinal cord to get an idea of how damaged it is, and everyone says it is impossible to view.

    Yet here it is. *sigh*

    Does anyone know of a place here in california with DTI? Perhaps Rancho?

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