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Early detection of cervical spondylotic myelopathy using diffusion tensor imaging: Experiences in 1.5-tesla magnetic resonance imaging


Ahmadli, Uzeyir; Ulrich, Nils H; Yuqiang, Yao; Nanz, Daniel; Sarnthein, Johannes; Kollias, Spyros S (2015). Early detection of cervical spondylotic myelopathy using diffusion tensor imaging: Experiences in 1.5-tesla magnetic resonance imaging. Neuroradiology Journal, 28(5):508-514.

Abstract

The purpose of this study was to investigate the usefulness of diffusion tensor imaging (DTI) for early detection of pathological alterations in the myelon in patients with cervical spondylotic myelopathy (CSM) without T2-weighted imaging (T2W) signal abnormalities but with a narrowed spinal canal with corresponding clinical correlation. Axial DTI at 1.5T together with routine magnetic resonance imaging was performed on 18 patients fulfilling above mentioned criteria. Quantitative fractional anisotropy (FA) and apparent diffusion coefficient (ADC) maps were generated. Values at the narrowest cervical levels were compared to pre- and poststenotic levels and the interindividual means were tested for statistically significant differences by means of paired t-tests. The correlation between the grade and width of canal stenosis in the axial plane was measured. FA was significantly reduced at the stenotic level, compared to prestenotic level, whereas no significant differences were found when compared to poststenotic level. No significant differences between ADC values at stenotic level versus both adjacent non-stenotic levels were found, suggesting very early stage of degeneration. ADC values correlated significantly with the width of the spinal canal at the prestenotic level, but not at the poststenotic level. Findings indicate sufficient robustness of routine implementation of DTI at 1.5T to detect abnormalities in the spinal cord of CSM patients, before apparent T2W signal abnormalities and marked clinical deterioration. Therefore, larger and long-term studies should be conducted to establish the DTI scalar metrics that would indicate early intervention for a better clinical outcome in patients with clinical signs of CSM.

Abstract

The purpose of this study was to investigate the usefulness of diffusion tensor imaging (DTI) for early detection of pathological alterations in the myelon in patients with cervical spondylotic myelopathy (CSM) without T2-weighted imaging (T2W) signal abnormalities but with a narrowed spinal canal with corresponding clinical correlation. Axial DTI at 1.5T together with routine magnetic resonance imaging was performed on 18 patients fulfilling above mentioned criteria. Quantitative fractional anisotropy (FA) and apparent diffusion coefficient (ADC) maps were generated. Values at the narrowest cervical levels were compared to pre- and poststenotic levels and the interindividual means were tested for statistically significant differences by means of paired t-tests. The correlation between the grade and width of canal stenosis in the axial plane was measured. FA was significantly reduced at the stenotic level, compared to prestenotic level, whereas no significant differences were found when compared to poststenotic level. No significant differences between ADC values at stenotic level versus both adjacent non-stenotic levels were found, suggesting very early stage of degeneration. ADC values correlated significantly with the width of the spinal canal at the prestenotic level, but not at the poststenotic level. Findings indicate sufficient robustness of routine implementation of DTI at 1.5T to detect abnormalities in the spinal cord of CSM patients, before apparent T2W signal abnormalities and marked clinical deterioration. Therefore, larger and long-term studies should be conducted to establish the DTI scalar metrics that would indicate early intervention for a better clinical outcome in patients with clinical signs of CSM.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Neuroradiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurosurgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:October 2015
Deposited On:25 Jan 2016 11:33
Last Modified:30 Aug 2016 07:30
Publisher:Sage Publications Ltd.
ISSN:1971-4009
Publisher DOI:https://doi.org/10.1177/1971400915609339
PubMed ID:26452521

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