The correlation between diffusion tensor imaging of the sacral cord and bladder contractility in people with tetraplegia.

Cross-sectional descriptive study. To compare the diffusion tensor imaging (DTI) changes of the sacral cord in people with complete cervical spinal cord injury (SCI) and neurogenic bladder versus people without SCI, and to explore the relationship between sacral cord DTI changes and bladder contractility. First Affiliated Hospital of Soochow University, Jiangsu Province, China. Forty participants were included: 25 participants with complete cervical SCI and 15 without SCI. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were calculated by DTI for ventral horn and intermediate column of sacral cord at S2–S4 level. All participants underwent urodynamic examination. The urodynamic parameters (voiding efficiency (VE), and bladder contractility index (BCI)) and DTI parameters were compared between people with and without SCI. The correlations between DTI values (FA and ADC) and urodynamic parameters were analyzed. The FA values were significantly lower and the ADC values were significantly higher in the intermediate column and ventral horn at S2–S4 level of the participants with SCI compared with their able-bodied counterparts (p   0.05). Complete cervical SCI might lead to microstructural changes of the sacral cord, which might further affect bladder contraction.