Magnetic resonance diffusion imaging of the human cervical spinal cord in vivo

Clark, Chris A.; Barker, Gareth J.; Tofts, Paul S.

doi:10.1002/(sici)1522-2594(199906)41:6<1269::aid-mrm26>3.0.co;2-2

Cited by 97 publications

(76 citation statements)

References 26 publications

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“…Water molecules, due to the limitation of the myelin sheath, moved rapidly along the white matter fiber tract but slowly along other directions. Diffusion anisotropy in the white matter of spinal cord was also confirmed in vivo by animal experiments in many literatures [5,7,10,11].…”

Section: Discussionmentioning

confidence: 58%

Diffusion tensor imaging in the cervical spinal cord

et al. 2010

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There are discrepancy between MR findings and clinical presentations. The compressed cervical cord in patients of the spondylotic myelopathy may be normal on conventional MRI when it is at the earlier stage or even if patients had severe symptoms. Therefore, it is necessary to take a developed MR technique-diffusion tensor imaging (DTI)-to detect the intramedullary lesions. Prospective MR and DTI were performed in 53 patients with cervical compressive myelopathy and twenty healthy volunteers. DTI was performed along six non-collinear directions with single-shot spin echo echo-planar imaging (EPI) sequence. Intramedullary apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values were measured in four segments (C2/3, C3/4, C4/5, C5/6) for volunteers, in lesions (or the compressed cord) and normal cord for patients. DTI original images were processed to produce color DTI maps. In the volunteers' group, cervical cord exhibited blue on the color DTI map. FA values between four segments had a significant difference (P \ 0.01), with the highest FA value (0.85 ± 0.03) at C2/3 level. However, ADC value between them had no significant difference (P [ 0.05). For patients, only 24 cases showed hyperintense on T2-weighted image, while 39 cases shown patchy green signal on color DTI maps. ADC and FA values between lesions or the compressed cord and normal spinal cord of patients had a significant difference (both P \ 0.01). FA value at C2/3 cord is the highest of other segments and it gradually decreases towards the caudal direction. Using single-shot spin echo EPI sequence and six non-collinear diffusion directions with b value of 400 s mm -2 , DTI can clearly show the intramedullary microstructure and more lesions than conventional MRI.

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Section: Discussionmentioning

confidence: 58%

Diffusion tensor imaging in the cervical spinal cord

et al. 2010

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“…17 This paper described the use of a navigated, cardiac-gated diffusion sensitised spin-echo method which produced sagittal ADC maps of the spinal cord with an in-plane resolution of 0.94 mm and slice thickness of 5 mm in 15 min for two directions of diffusion sensitisation. Figure 1(a) and (b) shows ADC maps of the cervical spine sensitized to diffusion in the superior-inferior (SI) direction along the cord (ADC SI ) and anterior-posterior (AP) direction (ADC AP ) perpendicular to the cord, respectively.…”

Section: Methodsmentioning

confidence: 99%

Diffusion tensor imaging in spinal cord: methods and applications – a review

Clark

Werring

2002

NMR in Biomedicine

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The spinal cord is a clinically eloquent site within the central nervous system, containing important sensorimotor tracts confined within a small cross-sectional area. Damage to the spinal cord may be caused by a wide range of pathologies, and can result in profound functional disability. Characterization of the structural integrity of the spinal cord can be assessed using diffusion tensor imaging methods. Development and application of this technique may improve our understanding of the nature and evolution of structural damage in spinal cord disease. Possible developments include improved detection of ischaemic lesions, clarification of the relationship between clinical disability and structural damage to the cord and monitoring of anti-inflammatory or neuroprotective therapies. In this review current technical aspects, clinical applications and the suggested future development of spinal cord diffusion imaging are discussed.

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“…For example, diffusion changes in the spinal cord have been reported after spinal artery stroke, 1 multiple sclerosis, 2 cervical spondylotic myelopathy, 3 spinal cord compression, 4 acute spinal cord injury, 5 and chronic spinal cord injury, 6,7 yet detailed baseline data with use of common imaging sequences are lacking for comparison. Some diffusion measurements have been documented in targeted regions of the neurologically intact human spinal cord, [8][9][10][11][12] and these values have been used for comparison to pathologic conditions; however, a comprehensive study of diffusion parameters throughout the entire spinal cord has not been reported. As a result, the primary purpose of this study was to characterize the normative diffusion values of the entire human spinal cord with use of a clinically available pulse sequence for comparison with pathologic conditions and new pulse sequence designs.…”

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confidence: 99%

“…Unfortunately, the main alternative to EPI, pulsed-gradient, spin-echo DTI, is highly sensitive to motion and has very long imaging times, requiring approximately 15 minutes to image a single diffusion axis. 9 A few pulse sequences focus on a compromise between these 2 methods, including line scan diffusion imaging, 13 multishot echo-planar imaging, 10 and fast single-shot EPI with use of sensitivitiy encoding (SENSE).…”

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confidence: 99%