Syringomyelia, include or exclude from studies?

Hi, I am using SCT to study spinal cord atrophy after spinal cord injury. Some of our subjects have syringomyelia (fluid filled cysts or expansion of the central canal within the cord), and I was wondering what the general approach to that would be. While spinal cord cross-sectional area can be calculated, I am not sure if it is appropriate to include such subjects in studies.

Best
Clas

Hi @Clas

This is a great question, which I was also wondering myself when encountering participants with syringomyelia. My take on this is that it depends what is the purpose of computing CSA. For example, if the purpose is to evaluate the amount of tissue atrophy (which seems to be the case in your study), then I would make sure to subtract the CSA of the syringomyelia area from the cord CSA that includes that area. This is of course more time consuming and it requires to segment the syringomyelia region. Maybe this could be done with sct_deepseg_lesion, but I’m not sure how well it will work (that function was originally developed to segment MS lesions, which look fairly different than syringomyelia).