The role of DTI in early detection of cervical spondylotic myelopathy: a preliminary study with 3-T MRI
The role of DTI in early detection of cervical spondylotic myelopathy: a preliminary study with 3-T MRI
复制标题
DOI：
10.1007/s00234-011-0844-4
复制
发表时间：
2011-08-01
期刊：
影响因子：
2.8
通讯作者：
Hamzaoglu, Azmi
中科院分区：
文献类型：
--
作者：
Kara, Batuhan;Celik, Azim;Hamzaoglu, Azmi
脊髓型颈椎病（CSM）的影像学诊断必须尽快作出，因为据报道，在CSM的过程中，在早期阶段进行手术是更成功的，与后期阶段相比。我们假设扩散张量成像（DTI）可以在脊髓T2加权像信号增高之前发现脊髓型颈椎病的早期病变，选择16例有脊髓型颈椎病神经系统症状和体征但T2加权像上无脊髓高信号的患者作为研究对象。磁共振（MR）检查在3-T MR成像系统上进行。在轴向平面上生成表观扩散系数（ADC）图和各向异性分数（FA）图。在最严重的颈椎管狭窄水平和非狭窄水平测量每个个体的ADC和FA。采用t检验比较狭窄段和非狭窄段脊髓FA和ADC值。我们还用Pearson相关分析来研究DTI参数与临床症状持续时间之间是否存在相关性。虽然狭窄水平的脊髓FA值显示出统计学显著性降低，但测量的ADC值有统计学显著性增加（p < 0.001）。症状持续时间和DTI参数之间无统计学相关性。我们的初步研究结果表明，脊髓型颈椎病患者在常规序列T2高信号出现之前，DTI可能显示脊髓异常。
The radiological diagnosis of cervical spondylotic myelopathy (CSM) has to be made as soon as possible, since surgery performed in earlier stages during the course of CSM was reported to be more successful when compared with later stages. We hypothesized that diffusion tensor imaging (DTI) may detect CSM in earlier stages, before the appearance of signal increase in T2-weighted sequences.A total of 16 patients with neurological signs and symptoms of CSM but without hyperintensity in spinal cord on T2-weighted sequences enrolled in the study. The magnetic resonance (MR) examinations were performed on a 3-T MR imaging system. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) maps were generated on axial plane. The ADC and FA measurements in each individual were made at the level of most severe cervical canal stenosis and at a nonstenotic level. Student's t test was used to compare FA and ADC values of the spinal cord in stenotic and nonstenotic segments. We also investigated if there was a correlation between DTI parametrics and duration of clinical symptoms by using Pearson correlation analysis.All patients showed changes in DTI parametrics at stenotic segments. While FA values of the spinal cord at the stenotic level showed a statistically significant reduction, there was a statistically significant increase in the measured ADC values (p < 0.001). There was no statistical correlation between the duration of symptoms and DTI parametrics.Our preliminary findings indicate that DTI may show abnormalities in the spinal cord before the development of T2 hyperintensity on conventional sequences in patients with CSM.