Altered gray matter volume and functional connectivity in adolescent borderline personality disorder with non-suicidal self-injury behavior.

BACKGROUND AND OBJECTIVES: Non-suicidal self-injury (NSSI) behavior is one of the characteristics of borderline personality disorder (BPD) in adolescents. Prior studies have shown that adolescents with BPD may have a unique pattern of brain alterations. The purpose of this study was to investigate the alterations in brain structure and function including gray matter volume and resting-state functional connectivity in adolescents with BPD, and to assess the association between NSSI behavior and brain changes on neuroimaging in adolescents with BPD. METHODS: 53 adolescents with BPD aged 12-17 years and 39 age-gender matched healthy controls (HCs) were enrolled into this study. Brain magnetic resonance imaging (MRI) was acquired with both 3D-T1 weighted structural imaging and resting-state functional imaging. Voxel-based morphometry (VBM) analysis for gray matter volume and seed-based functional connectivity (FC) analysis were performed for assessing gray matter volume and FC. Clinical assessment for NSSI, mood, and depression was also obtained. Correlative analysis of gray matter alterations with self-injury or mood scales were performed. RESULTS: There were reductions of gray matter volume in the limbic-cortical circuit and default mode network in adolescents with BPD as compared to HCs (FWE P < 0.05, cluster size ≥ 1000). The diminished gray matter volumes in the left putamen and left middle occipital gyrus were negatively correlated with NSSI in adolescents with BPD (r = - 0.277 and P = 0.045, r = - 0.422 and P = 0.002, respectively). Furthermore, there were alterations of FC in these two regions with diminished gray matter volumes (voxel P < 0.001, cluster P < 0.05, FWE corrected). CONCLUSIONS: Our results suggest that diminished gray matter volume of the limbic-cortical circuit and default mode network may be an important neural correlate in adolescent BPD. In addition, the reduced gray matter volume and the altered functional connectivity may be associated with NSSI behavior in adolescents with BPD.

Ensemble Machine Learning Model Incorporating Radiomics and Body Composition for Predicting Intraoperative HDI in PPGL.

CONTEXT: Intraoperative hemodynamic instability (HDI) can lead to cardiovascular and cerebrovascular complications during surgery for pheochromocytoma/paraganglioma (PPGL). OBJECTIVES: We aimed to assess the risk of intraoperative HDI in patients with PPGL to improve surgical outcome. METHODS: A total of 199 consecutive patients with PPGL confirmed by surgical pathology were retrospectively included in this study. This cohort was separated into 2 groups according to intraoperative systolic blood pressure, the HDI group (n = 101) and the hemodynamic stability (HDS) group (n = 98). It was also divided into 2 subcohorts for predictive modeling: the training cohort (n = 140) and the validation cohort (n = 59). Prediction models were developed with both the ensemble machine learning method (EL model) and the multivariate logistic regression model using body composition parameters on computed tomography, tumor radiomics, and clinical data. The efficiency of the models was evaluated with discrimination, calibration, and decision curves. RESULTS: The EL model showed good discrimination between the HDI group and HDS group, with an area under the curve of (AUC) of 96.2% (95% CI, 93.5%-99.0%) in the training cohort, and an AUC of 93.7% (95% CI, 88.0%-99.4%) in the validation cohort. The AUC values from the EL model were significantly higher than the logistic regression model, which had an AUC of 74.4% (95% CI, 66.1%-82.6%) in the training cohort and an AUC of 74.2% (95% CI, 61.1%-87.3%) in the validation cohort. Favorable calibration performance and clinical applicability of the EL model were observed. CONCLUSION: The EL model combining preoperative computed tomography-based body composition, tumor radiomics, and clinical data could potentially help predict intraoperative HDI in patients with PPGL.

Altered brain activity and cognitive impairment in patients with psoriasis.

BACKGROUND: Patients with psoriasis may have cognitive impairment. However, there is limited information regarding intrinsic brain activity and cognitive function in patients with psoriasis. OBJECTIVES: This study aim to assess alterations of intrinsic brain activity and its association with cognitive function in patients with psoriasis. METHODS: A total of 222 patients with psoriasis aged 18-70 years and 144 age and gender-matched healthy controls (HCs) were enrolled into this study. All subjects underwent brain resting-state functional magnetic resonance imaging (rs-fMRI) and neuropsychological testing. The rs-fMRI data were analysed for both intrinsic brain activity as indicated by amplitude of low-frequency fluctuation (ALFF) and seed-based functional connectivity (FC). Correlative analysis of brain activity with cognitive assessment was performed. RESULTS: Compared with the HCs, patients with psoriasis had worse cognitive performance in the Trail Making Test, Digit Span Test and Stroop Color-Word Test (p < 0.05). Patients with psoriasis showed decreased ALFF in the left superior frontal gyrus, the left medial superior frontal gyrus and the right precuneus gyrus; as well as enhanced ALFF in the left paracentral lobule (pFWE < 0.05). Significant correlations were noted between the altered ALFF in the four brain regions and cognitive assessment (p < 0.05). Moreover, patients with psoriasis had increased FC between the four brain regions with altered ALFF (seeds) and the left prefrontal gyrus, the left anterior cingulate gyrus, left superior parietal lobule and default mode network (DMN) regions such as the right precuneus gyrus, left inferior parietal lobule, right angular gyrus and bilateral inferior temporal gyrus (pFWE < 0.05). CONCLUSIONS: Patients with psoriasis had altered brain activity and connectivity in the key brain areas within the DMN-prefrontal circuit. These brain changes may be the underlying neural correlates for cognitive functioning in patients with psoriasis.

Altered resting-state functional connectivity and its association with executive function in adolescents with borderline personality disorder.

Adolescents with borderline personality disorder (BPD) may have impaired executive functions. There are few functional MRI (fMRI) studies in adolescents with BPD and the neuroimaging markers of this disorder are unknown. The aim of this study was to investigate the functional connectivity (FC) of BPD in adolescents, and to explore the relationship between FC changes and executive function in adolescents with BPD. 50 adolescents aged 12 to 17 years with BPD and 21 gender-and-age matched healthy controls (HC) were enrolled into the study. Brain MRI scan including a 3D-T1 weighted structural sequence and a resting-state fMRI was acquired. A seed-based FC analysis was performed. We used the Stroop color-word test (SCWT) and the trail making test (TMT) to evaluate the executive function of the participants. Correlative analysis of FC alterations with executive function and clinical symptoms was also performed. Compared to the HCs, adolescents with BPD showed increased FC in the limbic-cortical circuit, such as the FC between the left hippocampus and right parahippocampal gyrus, between the right middle occipital gyrus and the left middle temporal gyrus, and between the left medial superior frontal gyrus and the right inferior temporal gyrus. FC in the default mode network (DMN) was decreased between the left angular gyrus and the left precuneus but increased between the left angular gyrus and the right anterior cingulate cortex (voxel P < 0.001, cluster P < 0.05, FWE corrected). The BPD group demonstrated significantly lower cognitive testing scores than the HC group on the SCWT-A (P < 0.001), SCWT-B (P < 0.001), and SCWT-C (P = 0.034). The FC alterations between limbic system and cortical regions were associated with SCWT and TMT (P < 0.05). FC alterations were noted in both limbic-cortical circuit and DMN in adolescents with BPD, which were associated with impaired executive function. This study implicated the FC alterations as the neural correlates of executive functioning in adolescents with BPD.

Association of brain morphology and phenotypic profile in patients with unruptured intracranial aneurysm.

Introduction: Studies have found a varying degree of cognitive, psychosocial, and functional impairments in patients with unruptured intracranial aneurysms (UIAs), whereas the neural correlates underlying these impairments remain unknown. Methods: To examine the brain morphological alterations and white matter lesions in patients with UIA, we performed a range of structural analyses to examine the brain morphological alterations in patients with UIA compared with healthy controls (HCs). Twenty-one patients with UIA and 23 HCs were prospectively enrolled into this study. Study assessment consisted of a brain magnetic resonance imaging (MRI) scan with high-resolution T1-weighted and T2-weighted imaging data, a Montreal Cognitive Assessment (MoCA), and laboratory tests including blood inflammatory markers and serum lipids. Brain MRI data were processed for cortical thickness, local gyrification index (LGI), volume and shape of subcortical nuclei, and white matter lesions. Results: Compared to the HCs, patients with UIA showed no significant differences in cortical thickness but decreased LGI values in the right posterior cingulate cortex, retrosplenial cortex, cuneus, and lingual gyrus. In addition, decreased LGI values correlated with decreased MoCA score (r = 0.498, p = 0.021) and increased white matter lesion scores (r = -0.497, p = 0.022). The LGI values were correlated with laboratory values such as inflammatory markers and serum lipids. Patients with UIA also showed significant regional atrophy in bilateral thalami as compared to the HCs. Moreover, the LGI values were significantly correlated with thalamic volume in the HCs (r = 0.4728, p = 0.0227) but not in the patients with UIA (r = 0.11, p = 0.6350). Discussion: The decreased cortical gyrification, increased white matter lesions, and regional thalamic atrophy in patients with UIA might be potential neural correlates of cognitive changes in UIA.

Altered cortical thickness and emotional dysregulation in adolescents with borderline personality disorder.

Background: Emotional dysregulation is a core feature of borderline personality disorder (BPD). Previous studies have reported that abnormal grey matter volume is associated with the limbic-cortical circuit and default mode network (DMN) in patients with BPD. However, alterations of cortical thickness in adolescents with BPD have not been well evaluated.Objective: The aim of this study was to assess cortical thickness and its association with emotional dysregulation in adolescents with BPD.Method: This prospective study enrolled 52 adolescents with BPD and 39 age- and sex-matched healthy controls (HCs). Assessments included brain magnetic resonance imaging (MRI) acquisition with structural and resting-state functional MRI data, and clinical assessment for emotional dysregulation using the Difficulties in Emotion Regulation Scale (DERS). Cortical thickness and seed-based functional connectivity were analysed with FreeSurfer 7.2 software. Correlation analysis between cortical thickness and the scores from emotional assessment was performed with Spearman analysis.Results: Compared to HCs, there was altered cortical thickness in the DMN and limbic-cortical circuit in adolescents with BPD (Monte Carlo correction, all p < .05). These regions with altered cortical thickness were significantly associated with emotional dysregulation (all p < .05). There were also alterations of functional connectivity, i.e. with increased connectivity of the right prefrontal cortex with bilateral occipital lobes, or with the limbic system, and with decreased connectivity among the DMN regions (voxel p < .001, cluster p < .05, family-wise error corrected).Conclusions: Our results suggest that the altered cortical thickness and altered functional connectivity in the limbic-cortical circuit and DMN may be involved in emotional dysregulation in adolescents with BPD.

Emotional dysregulation is a core feature of borderline personality disorder, but the underlying neural correlates are not well known.There was altered cortical thickness and functional connectivity in the DMN and limbic­cortical circuit in adolescents with borderline personality disorder.Altered cortical thickness was associated with emotional dysregulation in adolescents with borderline personality disorder.

Alteration of surface morphology and core features in adolescents with borderline personality disorder.

BACKGROUND: Accurate early diagnosis of adolescent borderline personality disorder (BPD) is critical for prompt treatment. The aim of this study was to assess the alteration of brain surface morphology and to evaluate its relationship with core features in adolescent BPD. METHODS: A total of 52 adolescents with BPD aged 12-17 years and 39 age- and sex-matched healthy controls (HCs) were prospectively enrolled into the study. Brain magnetic resonance imaging (MRI) was obtained with both 3D-T1 weighted structural sequence and resting-state functional data. The structural data was analyzed for surface morphology parameters including the local gyrification index (LGI), mean curvature and surface area. The functional MRI data was analyzed for seed-based functional connectivity (FC). Correlative analysis of surface morphology and core features of adolescent BPD was performed. RESULTS: Adolescents with BPD showed the following altered surface morphology in the limbic-cortical circuit when compared to the HCs: (1) reduced LGI in the left fusiform and right superior temporal gyrus; (2) reduced mean curvature in the left precentral gyrus and right rostral anterior cingulate cortex, and increased mean curvature in the bilateral pericalcarine; and (3) reduced surface area in the left paracentral gyrus, left pars triangularis, right insula and right lateral orbitofrontal gyrus (P < 0.05, FWE correction). In addition, these brain regions with altered surface morphology were significantly correlated with several core features including the mood instability, self-identity problems, and non-suicidal self-injury behavior in adolescents with BPD (P < 0.05). Furthermore, there was enhanced functional connectivity among these altered brain regions within the limbic-cortical circuit (voxel P < 0.001, cluster P < 0.05, FWE corrected). CONCLUSIONS: Adolescents with BPD had significant alterations of brain surface morphology in the limbic-cortical circuit, which was correlated with core BPD features. These results implicated the surface morphology parameters and FC alterations may potentially serve as neuroimaging biomarkers for adolescents with BPD.

Altered brain activity and childhood trauma in Chinese adolescents with borderline personality disorder.

BACKGROUND: Childhood trauma may cause borderline personality disorder (BPD). The aim of this study was to assess functional alteration and its association with childhood trauma in Chinese adolescents with BPD. METHODS: A total of 187 adolescents with BPD aged 12-17 years and 207 age and gender- matched healthy controls (HCs) were enrolled into this study. The sample consisted of 50 adolescents with BPD and 21 HCs underwent brain resting-state functional magnetic resonance imaging (rs-fMRI). The rs-fMRI data was analyzed for both neural activity as indicated by amplitude of low-frequency fluctuation (ALFF) and seed-based functional connectivity (FC). Clinical assessment for childhood trauma, impulsivity, and depression was also performed. Correlative analysis of functional alterations with childhood trauma assessment were performed. RESULTS: Adolescents with BPD had significantly higher rate of all assessed childhood trauma than the HC group (P < 0.001). Most adolescents with BPD (61.5 %) had emotional neglect, which was the most commonly seen type of childhood trauma. Compared with HCs, adolescents with BPD showed decreased ALFF in the cortical regions including the left superior frontal gyrus and right middle occipital gyrus, and default mode network (DMN) regions including the left angular gyrus and medial superior frontal gyrus. Adolescents with BPD also showed enhanced ALFF in the limbic system (left hippocampus, insula, thalamus) (P < 0.05, FWE correction, cluster size ≥100). There were significant correlations between the insula ALFF and childhood trauma assessment for emotional neglect, physical abuse and physical neglect (P < 0.01). Moreover, adolescents with BPD showed increased FC between the left insula and right cortical regions (voxel P < 0.001, cluster P < 0.05, FWE correction). LIMITATIONS: The sample size was small. This cohort had patients with more severe BPD symptoms and some had comorbidities such as anxiety and obsessive-compulsive disorder. CONCLUSIONS: There were alterations of brain activity as indicated by ALFF in the limbic - cortical circuit and DMN regions in adolescents with BPD and the activity in the left insula was correlated with emotional neglect. In addition, the FC between the left insula and the limbic - prefrontal circuit was enhanced. These results implicate that the functional alterations of insula may serve as a potential neuroimaging biomarker for adolescents with BPD who suffered from childhood trauma.

CT radiomics identifying non-responders to neoadjuvant chemoradiotherapy among patients with locally advanced rectal cancer.

BACKGROUND AND PURPOSE: Early detection of non-response to neoadjuvant chemoradiotherapy (nCRT) for locally advanced colorectal cancer (LARC) remains challenging. We aimed to assess whether pretreatment radiotherapy planning computed tomography (CT) radiomics could distinguish the patients with no response or no downstaging after nCRT from those with response and downstaging after nCRT. MATERIALS AND METHODS: Patients with LARC who were treated with nCRT were retrospectively enrolled between March 2009 and March 2019. Traditional radiological characteristics were analyzed by visual inspection and radiomic features were analyzed through computational methods from the pretreatment radiotherapy planning CT images. Differentiation models were constructed using radiomic methods and clinicopathological characteristics for predicting non-response to nCRT. Model performance was assessed for classification efficiency, calibration, discrimination, and clinical application. RESULTS: This study enrolled a total of 215 patients, including 151 patients in the training cohort (50 non-responders and 101 responders) and 64 patients in the validation cohort (21 non-responders and 43 responders). For predicting non-response, the model constructed with an ensemble machine learning method had higher performance with area under the curve (AUC) values of 0.92 and 0.89 as compared to the model constructed with the logistic regression method (AUC: 0.72 and 0.71 for the training and validation cohorts, respectively). Both decision curve and calibration curve analyses confirmed that the ensemble machine learning model had higher prediction performance. CONCLUSION: Pretreatment CT radiomics achieved satisfying performance in predicting non-response to nCRT and could be helpful to assist in treatment planning for patients with LARC.

Preoperative Magnetic Resonance Imaging Radiomics for Predicting Early Recurrence of Glioblastoma.

PURPOSE: Early recurrence of glioblastoma after standard treatment makes patient care challenging. This study aimed to assess preoperative magnetic resonance imaging (MRI) radiomics for predicting early recurrence of glioblastoma. PATIENTS AND METHODS: A total of 122 patients (training cohort: n = 86; validation cohort: n = 36) with pathologically confirmed glioblastoma were included in this retrospective study. Preoperative brain MRI images were analyzed for both radiomics and the Visually Accessible Rembrandt Image (VASARI) features of glioblastoma. Models incorporating MRI radiomics, the VASARI parameters, and clinical variables were developed and presented in a nomogram. Performance was assessed based on calibration, discrimination, and clinical usefulness. RESULTS: The nomogram consisting of the radiomic signatures, the VASARI parameters, and blood urea nitrogen (BUN) values showed good discrimination between the patients with early recurrence and those with later recurrence, with an area under the curve of 0.85 (95% CI, 0.77-0.94) in the training cohort and 0.84 [95% CI, 0.71-0.97] in the validation cohort. Decision curve analysis demonstrated favorable clinical application of the nomogram. CONCLUSION: This study showed the potential usefulness of preoperative brain MRI radiomics in predicting the early recurrence of glioblastoma, which should be helpful in personalized management of glioblastoma.

Pre-symptomatic local brain activity and functional connectivity alterations in nasopharyngeal carcinoma patients who developed radiation encephalopathy following radiotherapy.

Radiation encephalopathy (RE) is a common complication in patients with nasopharyngeal carcinoma (NPC) who have received radiotherapy (RT), and recent neuroimaging studies have shown brain alterations in Post-RT patients prior to RE. However, whether there are functional alterations between those Post-RT patients who are proved to have RE in follow-up and those who do not develop it remains largely unknown. Here, we used resting state functional MRI to explore regional homogeneity (ReHo) and functional connectivity (FC) alterations in Post-RT patients with (Post-RT RE proved; n = 18) or without (Post-RT non-RE; n = 22) RE at follow-up, also making comparisons with a Pre-RT group (n = 23). Compared with the Pre-RT group, patients in Post-RT non-RE and Post-RT RE proved groups showed concurrent increased and decreased ReHo values in different brain regions inside and/or outside the radiation field, with the alterations in ReHo tending to increase if RE occurred. Seed-based FC analysis showed that compared with the Post-RT non-RE group, patients in the Post-RT RE proved group had different changing patterns of FC between a region of interest (ROI) in the right temporal lobe and distant brain regions (mainly in the sensorimotor system and default mode network). Receiver operating characteristic (ROC) curve analysis showed that the altered ReHo value in the ROI had excellent diagnostic performance for differentiating NPC patients who developed RE in follow-up from those who did not, with an area under the curve (AUC) value of 0.94. These ReHo and FC findings may provide new insights into the early diagnosis of RE.

[Magnetic resonance imaging features of glioma with Brg/Brm associated factor 53a expression].

OBJECTIVE: To explore the magnetic resonance imaging (MRI) characteristics of glioma with Brg/Brm-associated factor 53a (BAF53a) expression.
 Methods: A total of 121 patients with glioma was divided into a BAF53a high expression group (n=79) and a low expression group (n=42) according to the results of immunohistochemistry. Then the MRI characteristics, including lesion location, number, boundary, maximum diameter, peripheral edema, midline structure shift, homogeneity, cystic necrosis, hemorrhage, strengthening degree, ependymal strengthening, pia mater enhancement, deep white matter invasion and lesion across the midline (total 14 items), were analyzed.
 Results: The results showed that there were significance difference in lesion border, lesion edema, enhancement of the lesion, and deep white matter invasion between the 2 groups (all P<0.05).
 Conclusion: The MRI characteristics, such as lesion border, lesion edema degree, enhancement degree of the lesion and deep white matter invasion, might be associated with BAF53a expression in gliomas.

Predictors of long-term survival following postoperative radiochemotherapy for pathologically confirmed suprasellar germ cell tumors.

The aim of this study was to evaluate the predictors of long-term survival following postoperative therapy for suprasellar germ cell tumors (GCTs). A total of 23 patients with pathologically confirmed suprasellar GCTs were reviewed between April, 1987 and October, 2008. The predictors were identified with a univariate Cox proportional hazards model and the results were used to group patients according to outcome. The overall survival (OS) and progression-free survival (PFS) rates for the good- and poor-prognosis two groups were estimated with Kaplan-Meier analysis, with log-rank tests used to assess differences between the groups. The OS rate for all patients was 82.6% at 5 and 72.9% at 10 years. Lesion size (2-4 vs. >4 cm) and pathological type (pure germinoma vs. mixed GCT) were the only significant predictors of OS (P<0.05). The OS rate for the good-prognosis group was 92.9% at both 5 and 10 years, whereas the corresponding rates for the poor-prognosis group were 66.7 and 40.0%, respectively (P=0.020). The PFS rate for the good-prognosis group was 92.9% at 5 and 85.7% at 10 years, whereas the corresponding PFS rates for the poor-prognosis group were 44.4 and 33.3%, respectively (P=0.007). Lesion size and histology predicted outcome following postoperative therapy for suprasellar GCT. Therefore, pathological diagnosis is recommended whenever possible, as histology may dictate the choice of treatment.

[Clinical analysis of 45 patients with intracranial germinoma treated by radiotherapy].

OBJECTIVE: To report the prospective efficacy of 45 patients intracranial germinoma treated by radiotherapy and discuss its treatment. METHODS: From February 1998 to October 2007, a total of 45 intracranial germinoma patients were performed radiotherapy, including 15 combined chemotherapy in the Department of Oncology. Of them 23 were pathologically diagnosed while 22 cases were clinical diagnosed. Life table method showed the 5-year and 10-year survival rate. RESULTS: Forty patients were followed-up. Most symptoms of the patients were significantly reduced or disappeared completely. The 5-year and 10-year survival rate of all patients were 84% and 74%. CONCLUSION: Radiotherapy is the main treatment for intracranial germinoma. Craniospinal irradiation, whole brain irradiation and partial brain irradiation are the main treatments. Radiotherapy combined with chemotherapy, which can reduce the radiation range and dose will be the trend.

Nimotuzumab prolongs survival in patients with malignant gliomas: A phase I/II clinical study of concomitant radiochemotherapy with or without nimotuzumab.

The present study aimed to determine whether nimotuzumab enhances the effect of radiochemotherapy in malignant gliomas. Patients (n=41) with malignant gliomas were divided into 20 cases (treatment group) in which nimotuzumab plus radiochemotherapy were offered and 21 cases (control group) in which placebo and radiochemotherapy were administered to the patients. The response to treatment was evaluated according to the Response Evaluation Criteria in Solid Tumors, the Kaplan-Meier method was used to calculate the mean and median survival times and 1-year survival rate, and the log-rank test and the Chi-square test were used to analyze the difference in the survival and response rate between the treatment and control groups. The mean survival times of the treatment and control groups were 14.3 and 10.4 months and the median survival times of the treatment and control groups were 16.5 and 10.5 months, respectively. The 1-year survival rates of the treatment and control groups were 81.3 and 69.1%, respectively, with no significant difference (P>0.05). The objective response rates of the treatment and control groups were 70.0 and 52.4%, respectively, with no significant difference (P>0.05). In conclusion, there was a trend towards improved treatment efficacy of radiochemotherapy combined with nimotuzumab against malignant gliomas. This study demonstrated that the use of nimotuzumab combined with radiotherapy and concomitant temozolomide chemotherapy is effective for malignant gliomas.

[Diffusion-weighted magnetic resonance imaging for acute trauma of the spine cord].

OBJECTIVE: To determine the clinical value of diffusion-weighted magnetic resonance imaging (DWI) for acute trauma of the spinal cord. METHODS: Sixteen patients with acute trauma of the spinal cord were examined with routine magnetic resonance imaging (MRI) and ssh-EPI-DWI, on a 1.5-tesla MR system within 72 h trauma. RESULTS: All the 16 patients were examined by MRI and ssh-EPI-DWI: 6 patients were negative and 10 were positive in MRI, which showed local lesions with significant abnormality. Positive cases were classified into 2 categories depending on different degrees of tissue injury and characteristics of DWI. (1) Edema-type: 7 presented DWI high signals with different degrees in local lesions. (2) Mixed-type: 3 showed DWI heterogeneous high signals due to hemorrhage and edema in the lesions. There was significant difference in ADC values between the lesions and normal parts (t=-7.719, P<0. 01). CONCLUSION: ssh-EPI-DWI of the spinal cord may provide satisfactory images and is a useful method for visualizing the injury in the superearly stage, helpful to determine the integrity and compression degree of the spinal cord.