Magnetization Transfer Ratio and Morphometrics of the Spinal Cord Associates with Surgical Recovery in Patients with Degenerative Cervical Myelopathy.
Magnetization Transfer Ratio and Morphometrics of the Spinal Cord Associates with Surgical Recovery in Patients with Degenerative Cervical Myelopathy.
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DOI：
10.1016/j.wneu.2020.09.148
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发表时间：
2020-12
影响因子：
2
通讯作者：
Smith ZA
中科院分区：
文献类型：
--
作者：
Paliwal M;Weber KA 2nd;Hopkins BS;Cantrell DR;Hoggarth MA;Elliott JM;Dahdaleh NS;Mackey S;Parrish TD;Dhaher Y;Smith ZA
在一项纵向队列研究中，我们评估了退行性颈椎病（DCM）患者术前磁化传递比（MTR）和脊髓形态计量学的预后价值。13例DCM患者行3T磁化转移成像。计算脊髓区域和特定白质束的MTR。提取形态计量测量值。评估颈椎减压手术前后临床（改良日本骨科协会[mJOA]和Nurick量表评分）和健康相关生活质量评分。评估磁共振成像（MRI）指标与术后恢复之间的关系（Spearman相关）。使用受者操作特征来评估MRI指标识别≥50%功能恢复的准确性。术前前脐带MTRs与mJOA评分恢复相关（ρ = 0.608; P = 0.036；曲线下面积[AUC]， 0.66）。术前侧索MTR与颈部失能指数（ρ = 0.699; P = 0.011）和疼痛干扰量表（ρ = 0.732; P = 0.007）相关。术前红脊髓束MTR与mJOA评分恢复相关（ρ = 0.573; P = 0.041； AUC, 0.86）。术前皮质脊髓束和网状脊髓MTRs与疼痛干扰评分的恢复相关（ρ = 0.591; P = 0.033; ρ = 0.583; P = 0.035）。脐带偏心率与Nurick评分（ρ = 0.606; P = 0.028）和mJOA评分（ρ = 0.651; P = 0.025； AUC, 0.92）相关。术前MTR和脊髓偏心测量在评估DCM患者对手术的反应和恢复方面具有预后价值。先进的MRI和基于图谱的后处理技术可以为DCM患者的干预提供信息，并提高他们接受的医疗保健水平。
We assessed the prognostic value of the preoperative magnetization transfer ratio (MTR) and morphometrics of the spinal cord in patients with degenerative cervical myelopathy (DCM) in a longitudinal cohort study. Thirteen subjects with DCM underwent 3T magnetization transfer imaging. The MTR was calculated for the spinal cord regions and specific white matter tracts. Morphometric measures were extracted. Clinical (modified Japanese Orthopaedics Association [mJOA] and Nurick scale scores) and health-related quality of life scores were assessed before and after cervical decompression surgery. The association between the magnetic resonance imaging (MRI) metrics and postoperative recovery was assessed (Spearman’s correlation). Receiver operating characteristics were used to assess the accuracy of MRI metrics in identifying ≥50% recovery in function. Preoperative anterior cord MTRs were associated with recovery in mJOA scores (ρ = 0.608; P = 0.036; area under the curve [AUC], 0.66). Preoperative lateral cord MTR correlated with the neck disability index (ρ = 0.699; P = 0.011) and pain interference scale (ρ = 0.732; P = 0.007). Preoperative rubrospinal tract MTR was associated with mJOA score recovery (ρ = 0.573; P = 0.041; AUC, 0.86). Preoperative corticospinal tract and reticulospinal MTRs were related to recovery in pain interference scores (ρ = 0.591; P = 0.033; and ρ = 0.583; P = 0.035, respectively). Eccentricity of the cord was associated with Nurick scores (ρ = 0.606; P = 0.028) and mJOA scores (ρ = 0.651; P = 0.025; AUC, 0.92). Preoperative MTR and eccentricity measurements of the spinal cord have prognostic value in assessing the response to surgery and recovery in patients with DCM. Advanced MRI and atlas-based postprocessing techniques can inform interventions and advance the healthcare received by patients with DCM.
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