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PUBLISHED WORK

medRxiv

January 4, 2024  

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CONTRAST-ENHANCED ULTRASOUND FOR ASSESSING TISSUE PERFUSION AND PREDICTING FUNCTIONAL RECOVERY FOLLOWING ACUTE TRAUMATIC SPINAL INJURY: TRANSLATION FROM RAT MODEL TO HUMANS 

Zin Z. Khaing, Jannik, Leyendecker, Jennifer N. Harmon, Sananthan Sivakanthan, Lindsay N. Cates, Jeffrey E. Hydes, Melissa Krueger, Robb W. Glenny, Matthew Bruce, Christoph P. Hofstetter

"This paper introduces a novel biomarker utilizing contrast-enhanced ultrasound in humans and rats that accurately predicts injury severity after traumatic spinal cord injury based on tissue perfusion."

Scientific Reports

December 19, 2022

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QUANTITATIVE TISSUE PERFUSION IMAGING USING NONLINEAR ULTRASOUND LOCALIZATION MICROSCOPY 

Jennifer N. Harmon , Zin Z. Khaing, Jeffrey E. Hyde, Christoph P. Hofstetter, Charles Tremblay-Darveau, and Matthew F. Bruce

The study introduces nonlinear ultrasound localization microscopy (ULM), a novel technique enhancing vascular imaging beyond the classical diffraction limit by utilizing microbubble contrast agents. Unlike conventional methods, nonlinear ULM enables visualization of blood flow at the tissue perfusion level, offering improved resolution and quantitative features for assessing microcirculatory flow. Using rat spinal cord models, nonlinear ULM demonstrates superior resolution in smaller branching vasculature and enables the investigation and potential quantification of tissue perfusion, a critical aspect of blood flow assessment. 

Toxins

November 10, 2022

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EARLY DETRUSOR APPLICATION OF BOTULINUM TOXIN A RESULTS IN REDUCED BLADDER HYPERTROPHY AND FIBROSIS AFTER SPINAL CORD INJURY IN A RODENT MODEL 

Juliana Y. Bushnell, Lindsay N. Cates, Jeffrey E. Hyde, Christoph P. Hofstetter, Claire C. Yang, Zin Z. Khaing

In a rodent model of spinal cord injury (SCI), early bladder chemodenervation with botulinum toxin A (BoNT-A) resulted in reduced bladder weight and thinner bladder walls compared to saline injection. Histological analysis showed that BoNT-A-treated bladders had collagen organization similar to uninjured bladders, suggesting that detrusor chemodenervation following SCI preserves bladder tissue integrity by mitigating detrusor fibrosis and hypertrophy. 

Ultrasound in Medicine and Biology

August 1, 2022 

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BLOOD FLOW CHANGES ASSOCIATED WITH SPINAL CORD INJURY ASSESSED BY NON-LINEAR DOPPLER CONTRAST-ENHANCED ULTRASOUND

Matthew Bruce, Dane Dewees, Jennifer N. Harmon, Lindsay Cates, Zin Z. Khaing, and Christoph P. Hofstetter 

The study demonstrates the clinical utility of contrast-enhanced ultrasound (CEUS) in assessing acute and chronic blood flow changes in contused spinal cords, using higher imaging frequencies (15 MHz) to simultaneously visualize micro- and macrocirculations. Significant differences in perfusion deficit and microbubble arrival time were observed between moderate and severe injuries, with acute morphological changes in central sulcal arteries correlating with chronic locomotive function and histological estimates of spared spinal cord tissue. 

Journal of Neurotrauma

March 15, 2021

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EFFECT OF DUROTOMY VERSUS MYELOTOMY ON TISSUE SPARING AND FUNCTIONAL OUTCOME AFTER SPINAL CORD INJURY

Zin Z. Khaing, Lindsay N. Cates, Dane M. Dewees, Jeffrey E. Hyde, Ashley Gaing, Zeinab Birjandian, and Christoph P. Hofstetter

 

The study compares the effects of durotomy alone and durotomy plus myelotomy in a rodent model of acute thoracic traumatic spinal cord injury (tSCI). Both surgical approaches effectively reduce elevated intraspinal pressure and promote tissue sparing, with durotomy plus myelotomy showing superior results in spinal tissue preservation and motor neuron preservation. While both surgeries contribute to locomotor function recovery, durotomy alone benefits bladder and Ladder Walk performance, suggesting a need for biomarkers to identify optimal surgical strategies for specific spinal cord injuries. 

Journal of Neurotrauma

October 29, 2020

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THE EFFECT OF DUROTOMY VERSUS MYELOTOMY ON TISSUE SPARING AND FUNCTIONAL OUTCOME AFTER SPINAL CORD INJURY

Zin Z. Khaing, Lindsay N. Cates, Dane M. Dewees, Jeffrey E. Hyde, Ashley Gaing, Zeinab Birjandian, and Christoph P. Hofstetter

Surgical decompression of either the dural (durotomy) or the dural and pial (myelotomy) lining of the spinal cord has been proposed. We compare the histological and functional effects of durotomy alone and durotomy + myelotomy in a rodent model of acute thoracic tSCI. Our data suggest that durotomy + myelotomy following acute tSCI facilitates tissue sparing and recovery of locomotor function. 

Military Medicine

February 19, 2020

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CONTRAST-ENHANCED ULTRASOUND FOR ASSESSMENT OF LOCAL HEMODYNAMIC CHANGES FOLLOWING A RODENT CONTUSION SPINAL CORD INJURY

Zin Z. Khaing, Lindsay N. Cates, Jeffrey Hyde, Dane M. Dewees, Ryan Hammond, Matthew Bruce, Christoph P. Hofstetter

CEUS imaging showed that traumatic SCI results in an area with significant loss of perfusion, which increased during the first hour after injury, structural alterations of the spinal cord vasculature, and significant slowing of arterial blood flow velocities around the injury epicenter.

Spinal Cord

January 21, 2020

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TRANSCUTANEOUS CONTRAST-ENHANCED ULTRASOUND IMAGING OF THE POST-TRAUMATIC SPINAL CORD

Zin Z. Khaing, Lindsay N. Cates, Jeffrey E. Hyde, Ryan Hammond, Matthew Bruce, Christoph P. Hofstetter

"This study aims to test whether the blood flow within the contused spinal cord can be assessed in a rodent model via the acoustic window of the laminectomy utilizing transcutaneous ultrasound. We report that transcutaneous ultrasound allows for measurements and longitudinal monitoring of local hemodynamic changes in a rodent SCI model."

Journal of Neurosurgery

September 19, 2018

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CONTRAST-ENHANCED ULTRASOUND TO VISUALIZE HEMODYNAMIC CHANGES AFTER RODENT SPINAL CORD INJURY

Zin Z. Khaing, Lindsay N. Cates, Dane M. Dewees, Alexander Hannah, Pierre Mourad, Matthew Bruce, and Christoph P. Hofstetter

"In our current report, we introduce ultrafast CEUS Doppler for monitoring of spinal vascular structure and function in real time. Development and clinical implementation of this type of imaging could have a significant impact on the care of patients with tSCI."

Journal of Neurotrauma

February 1, 2017

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TEMPORAL AND SPATIAL EVOLUTION OF RAISED INTRASPINAL PRESSURE AFTER TRAUMATIC SPINAL CORD INJURY

Zin Z. Khaing, Lindsay N. Cates, Amanda E. Fischedick, Abbi M. McClintic, Pierre D. Mourad, and Christoph P. Hofstetter

"Here, we report on the temporal and spatial patterns of elevated ISP following a moderate rodent contusion SCI.  Our findings suggest that a rat contusion SCI model in combination with novel micro-catheters allows for direct measurement of ISP after SCI. Similarly to traumatic brain injury, raised tissue pressure is likely to have detrimental effects on spontaneous recovery following SCI."

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MORE PUBLICATIONS

Individual Work, Prior Work, Case Studies, Collaborations, etc.

Publications: CV

IMAGING METHODS FOR ULTRASOUND CONTRAST AGENTS

March 2020

MA Averkiou, MF Bruce, JE Powers, PS Sheeran, PN Burns

TRANSCUTANEOUS ELECTRICAL SPINAL STIMULATION PROMOTES LONG-TERM RECOVERY OF UPPER EXTREMITY FUNCTION IN CHRONIC TETRAPLEGIA

May 8, 2018

F Inanici, S Samejima, P Gad, VR Edgerton, CP Hofstetter, CT Moritz

BIOMIMETIC HYDROGELS DIRECT SPINAL PROGENITOR CELL DIFFERENTIATION AND PROMOTE FUNCTIONAL RECOVERY AFTER SPINAL CORD INJURY

Feb 14, 2018

SA Geissler, AL Sabin, RR Besser, OM Gooden, BD Shirk, QM Nguyen, ZZ Khaing, CE Schmidt

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