Microstructural Changes in Compressed Cervical Spinal Cord Are Consistent With Clinical Symptoms and Symptom Duration
Microstructural Changes in Compressed Cervical Spinal Cord Are Consistent With Clinical Symptoms and Symptom Duration
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受压颈脊髓的微观结构变化与临床症状和症状持续时间一致
DOI：
10.1097/brs.0000000000003480
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发表时间：
2020-08-15
期刊：
影响因子：
3
通讯作者：
Liang, Jie
中科院分区：
文献类型：
--
作者：
Wu, Weifei;Yang, Zong;Liang, Jie
研究设计。前瞻性研究。目的。目的探讨单平位影响的脊髓型颈椎病（CSM）患者弥散张量成像（DTI）显微结构改变与临床症状及持续时间的关系。背景资料摘要。关于单节段脊髓压迫的显微结构改变与症状及其持续时间之间的关系，尚无报道。29例连续CSM患者和29例正常受试者被纳入本研究。颈脊髓行DTI伴脊髓束造影。采用改良的日本骨科协会（mJOA）评分对每位患者进行临床症状评估，并根据最早出现的肢体疼痛、麻木、无力或膀胱功能障碍记录临床症状的持续时间。平均分数各向异性（FA）值和表观扩散系数（ADC）值由示踪成像计算得到。颈椎受压脊髓的平均FA值显著低于正常人群（P < 0.001）。颈压缩脊髓的平均ADC值明显高于正常颈脊髓（P < 0.001）。在CSM患者中，FA值与mJOA评分显著正相关（P < 0.001）。mJOA评分与ADC值呈显著负相关（P < 0.001）， mJOA评分与症状持续时间呈显著负相关（P < 0.001）。这些结果表明DTI可以测量颈脊髓的微观结构变化，DTI参数是CSM患者脊髓功能障碍的潜在生物标志物。
Study Design. A prospective study.Objective. To investigate the association between microstructural changes measured by diffusion tensor imaging (DTI) and clinical symptoms and their duration in patients with cervical spondylotic myelopathy (CSM) affected by single level.Summary of Background Data. No report was reported regarding the association between the microstructural changes and the symptoms and their duration at single-level spinal cord compression.Methods. Twenty-nine consecutive patients with CSM and 29 normal subjects were enrolled in this study. DTI with tractography was performed on the cervical spinal cord. Clinical symptoms were evaluated using modified Japanese Orthopaedic Association (mJOA) scores for each patient, and the duration of clinical symptoms was noted based on the earliest instance of limb pain or numbness or weakness or bladder dysfunction. Mean fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were calculated from tractography images.Results. The mean FA value of the cervical compressed spinal cord was significantly lower than the FA of the normal population (P < 0.001). The mean ADC value in the cervical compressed spinal cord was obviously higher than those of normal cervical spinal cord (P < 0.001). In the CSM patients, a significant positive association was observed between FA values and mJOA scores (P < 0.001). However, there were a notable negative association between mJOA scores and ADC values (P < 0.001), and between mJOA scores and symptom duration (P < 0.001).Conclusion. These results illustrate DTI can measure the micostructural changes of cervical spinal cord and DTI parameters are potential biomarkers for spinal cord dysfunction in patients with CSM.