Usefulness of diffusion tensor MR imaging in the assessment of intramedullary changes of the cervical spinal cord in different stages of degenerative spine disease
Usefulness of diffusion tensor MR imaging in the assessment of intramedullary changes of the cervical spinal cord in different stages of degenerative spine disease
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DOI：
10.1007/s00586-014-3323-x
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发表时间：
2014-07-01
影响因子：
2.8
通讯作者：
Sasiadek, Marek
中科院分区：
文献类型：
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作者：
Banaszek, Anna;Bladowska, Joanna;Sasiadek, Marek
本研究的目的是评估弥散张量成像（DTI）在不同阶段退行性脊柱疾病中检测颈脊髓完整性改变的有效性，并将DTI参数与选定的颈椎狭窄测量值进行比较。研究共纳入不同分期颈椎病症状患者132例（平均年龄53.58岁）和对照组25例（平均年龄45.78岁）。DTI采用1.5 T MR扫描仪。对C2/C3至C5/C6的349个脊柱节段进行评估，并根据脊髓受压程度分为5组。计算各向异性分数（FA）和表观扩散系数，并分析其与狭窄程度的相关性。在对照组和颈椎退行性疾病患者（包括在MR平片上未见脊髓压迫的受试者）之间，FA值在所有水平上均有显著差异（p < 0.0001）。在所有研究水平上，平均FA值与椎管前后径以及脊髓指数可用空间呈正相关（p < 0.01）。DTI能够在退行性脊柱疾病的早期阶段，甚至在mr平片上可见脊髓压迫之前，揭示颈脊髓微结构的损害，脊髓正前方椎管直径以及脊髓可用空间指数与DTI定义的脊髓组织完整性密切相关。
The aim of this study was to evaluate the usefulness of diffusion tensor imaging (DTI) in the detection of cervical spinal cord integrity alterations in different stages of degenerative spine disease, as well as to compare DTI parameters with selected cervical spinal stenosis measurements.One hundred and thirty-two symptomatic patients (mean age 53.58 years) with different stages of cervical spondylosis and twenty-five control subjects (mean age 45.78 years) were enrolled in the study. DTI was performed with a 1.5 T MR scanner. Three hundred and forty-nine spine segments from C2/C3 to C5/C6 were evaluated and divided into five groups according to the degree of spinal cord compression. The values of fractional anisotropy (FA) and apparent diffusion coefficient at each level were calculated and their correlations with the degree of stenosis were analyzed.FA values differed significantly (p < 0.0001) at all levels between the control group and patients with cervical degenerative disease, including subjects without spinal cord compression visible on plain MR images. A significant (p < 0.01) positive correlation between the mean FA values and anteroposterior diameter of the spinal canal as well as space available for the spinal cord index was demonstrated at all investigated levels.DTI is capable of revealing impairment of the cervical spinal cord microstructure at the very early stage of degenerative spine disease, even prior to spinal cord compression visible on plain MR. Anteroposterior spinal canal diameter as well as space available for the cord index is well related to spinal cord tissue integrity defined by DTI.