Morphology and morphometry in chronic spinal cord injury assessed using diffusion tensor imaging and fuzzy logic.

Diffusion tensor imaging (DTI) using a combination of direct anisotropy measurements provided a more anatomically accurate morphological representation of the human spinal cord than traditional anisotropy indices. Furthermore, the use of a fuzzy logic algorithm to segment regions of gray and white matter within the spinal cord based on these anisotropy measurements allowed for morphometric analyses. Results indicated a significant decrease in overall spinal cord cross-sectional area, dorsal funiculus cross-sectional area, and lateral funiculi cross-sectional area in subjects with injury compared to the neurologically intact control subjects. Results also showed individuals with caudal injuries had a morphology and morphometry that was more similar to that of the control subjects, which is consistent with the process of Wallerian degeneration and has been illustrated by previous investigations involving animal surrogates.