Longitudinal diffusion tensor imaging of patients with degenerative cervical myelopathy following decompression surgery
Longitudinal diffusion tensor imaging of patients with degenerative cervical myelopathy following decompression surgery
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DOI：
10.1016/j.jocn.2019.05.018
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发表时间：
2020-04
影响因子：
2
通讯作者：
Mitsuhiro Kitamura;S. Maki;M. Koda;T. Furuya;Yasushi Iijima;J. Saito;Takuya Miyamoto;Yasuhiro Shiga;K. Inage;S. Orita;Hiroshi Takahashi;K. Matsumoto;Y. Masuda;M. Yamazaki;S. Ohtori
中科院分区：
文献类型：
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作者：
Mitsuhiro Kitamura;S. Maki;M. Koda;T. Furuya;Yasushi Iijima;J. Saito;Takuya Miyamoto;Yasuhiro Shiga;K. Inage;S. Orita;Hiroshi Takahashi;K. Matsumoto;Y. Masuda;M. Yamazaki;S. Ohtori
先前的研究已经报道了扩散张量成像（DTI）作为退行性脊髓颈病变（DCM）患者脊髓病变严重程度和后续手术结局的成像生物标志物的实用性。我们假设DTI可以反映手术后神经功能的恢复。本研究的目的是评估DTI评估扩张型心肌病患者术后神经状态变化以及预测术后恢复的能力。我们招募了15名接受减压手术的DCM患者。术前和术后1年评价日本骨科协会（乔亚）评分。术前及术后1年在3.0T磁共振扫描仪上进行DTI检查。评估两个时间点的各向异性分数（FA）和平均扩散率（MD）。分析术前和术后FA和MD值与术前和术后乔亚评分之间的相关性。尽管术后乔亚评分从8.9显著改善至12.3，但术前和术后FA和MD值之间无显著变化。1年后的术后结局与术前FA值中度相关（对于乔亚评分的变化率和恢复率，分别为斯皮尔曼ρ = 0.55，p = 0.03和斯皮尔曼ρ = 0.56，p = 0.03）。然而，术后FA与术后乔亚评分之间以及MD与临床结局之间均无相关性。DTI不能用作术后脊髓神经状态改变的生物标志物;然而，术前DTI可用作手术结果的预测因子。
Previous studies have reported the utility of diffusion tensor imaging (DTI) as an imaging biomarker for the severity of myelopathy and subsequent surgical outcome in patients with degenerative cervical myelopathy (DCM). We hypothesized that DTI may reflect neurological recovery following surgery. The purpose of this study was to evaluate the ability of DTI to assess the post-operative alteration of neural status in patients with DCM as well as to predict post-operative recovery. We enrolled 15 patients with DCM who underwent decompression surgery. The Japanese Orthopaedic Association (JOA) score was evaluated before and 1 year after surgery. The participants were examined using DTI on a 3.0 T magnetic resonance scanner before, and 1 year after surgery. Fractional anisotropy (FA) and mean diffusivity (MD) were assessed for both time points. The correlations between the pre- and post-operative FA and MD values and the pre- and post-operative JOA scores were analyzed. Although the JOA score improved significantly after surgery from 8.9 to 12.3, there was no significant change between the pre- and post-operative FA and MD values. The post-operative outcomes after 1 year moderately correlated with the pre-operative FA values (Spearman’s ρ = 0.55, p = 0.03 and Spearman’s ρ = 0.56, p = 0.03 for change and recovery rate of the JOA score, respectively). However, there was no correlation between the post-operative FA and post-operative JOA scores nor between MD and clinical outcomes. DTI cannot be utilized as a biomarker for post-operative alterations of neural status of the spinal cord; however, pre-operative DTI may be useful as a predictor of surgical outcomes.