Magnetic Resonance Diffusion Tensor Imaging in Patients With Cervical Spondylotic Spinal Cord Compression

Keřkovský, Miloš; Bednařík, Josef; Dušek, Ladislav; Šprláková-Puková, Andrea; Urbánek, Igor; Mechl, Marek; Válek, Vlastimil; Kadaňka, Zdeněk

doi:10.1097/brs.0b013e31820e6c35

Cited by 100 publications

(110 citation statements)

References 43 publications

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“…Kerkovsky et al [23], in a recent paper comparing diffusion tensor MR imaging with clinical findings, explored the usage of relative FA and ADC indices, which are the ratio of FA and ADC values derived from the unaffected segments (i.e. C2/C3 level) to the values obtained from the levels of spinal cord compression in one individual.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of diffusion tensor MR imaging in the assessment of intramedullary changes of the cervical spinal cord in different stages of degenerative spine disease

et al. 2014

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Purpose 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. Methods 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.Results 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. Conclusion 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.

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Section: Discussionmentioning

confidence: 99%

Usefulness of diffusion tensor MR imaging in the assessment of intramedullary changes of the cervical spinal cord in different stages of degenerative spine disease

et al. 2014

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“…Clinical findings correlate with DTI metrics of the injured spinal cord (Budzik, Balbi et al 2011;Chang, Jung et al 2010;Kim, Loy et al 2010;Qian, Chan et al 2011). Few studies have explored the relationship between structural integrity, evaluated using DTI, and physiological function of the human spinal cord Kerkovsky, Bednarik et al 2011;Qian, Chan et al 2011). However, to prove the validity of a technique that may be used to monitor the effects of new therapeutic interventions it is crucial to firstly prove its potential to reflect the functionality of the evaluated structures.…”

Section: Introductionmentioning

confidence: 99%

Chronic Cervical Spinal Cord Injury: DTI Correlates with Clinical and Electrophysiological Measures

Petersen

Wilm

Meyenburg

et al. 2012

Journal of Neurotrauma

113

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Diffusion tensor imaging (DTI) is rarely applied in spinal cord injury (SCI). The aim of this study was to correlate diffusion properties after SCI with electrophysiological and neurological measures. Nineteen traumatic cervical SCI subjects and 28 age-matched healthy subjects participated in this study. DTI data of the spinal cord were acquired with a Philips Achieva 3 T MR scanner using an outer volume suppressed, reduced field of view (FOV) acquisition with oblique slice excitation and a single-shot EPI readout. Neurological and electrophysiological measures, American Spinal Injury Association (ASIA) impairment scale scores, and motor (MEP) and somatosensory evoked potentials (SSEP) were assessed in SCI subjects. Fractional anisotropy (FA) values were decreased in the SCI subjects compared to the healthy subjects. In upper cervical segments, the decrease in FA was significant for the evaluation of the entire cross-sectional area of the spinal cord, and for corticospinal and sensory tracts. A decreasing trend was also found at the thoracic level for the corticospinal tracts. The decrease of DTI values correlated with the clinical completeness of SCI, and with SSEP amplitudes. The reduced DTI values seen in the SCI subjects are likely due to demyelination and axonal degeneration of spinal tracts, which are related to clinical and electrophysiological measures. A reduction in DTI values in regions remote from the injury site suggests their involvement with wallerian axonal degeneration. DTI can be used for the quantitative evaluation of the extent of spinal cord damage, and eventually to monitor the effects of future regeneration-inducing treatments. This article has been peer-reviewed and accepted for publication, but has yet to undergo copyediting and proof correction. The final published version may differ from this proof. This article has been peer-reviewed and accepted for publication, but has yet to undergo copyediting and proof correction. The final published version may differ from this proof. Abstract

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“…Our investigation in 40 healthy subjects established that T2*WI WM/GM has lower intersubject variability compared with CSA, FA, and MTR and superior reliability compared with FA and MTR, 7 though the latter metrics showed acceptable results, in keeping with prior reports. 11,[21][22][23][24][25] These encouraging findings prompted the current study in degenerative cervical myelopathy (DCM), a common condition involving degeneration of the discs, ligaments, and vertebrae, resulting in cervical spinal cord compression and functional impairment (Fig 1). 26,27 We aimed to determine how well T2*WI WM/GM differs between patients with DCM and healthy subjects and correlates with global disability and focal neurologic deficits when extracted from corresponding regions of WM, in comparison with FA, MTR, and CSA of the SC.…”

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confidence: 99%

A Novel MRI Biomarker of Spinal Cord White Matter Injury: T2*-Weighted White Matter to Gray Matter Signal Intensity Ratio

Martín¹,

Leener

Cohen‐Adad

et al. 2017

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: T2*-weighted imaging provides sharp contrast between spinal cord GM and WM, allowing their segmentation and cross-sectional area measurement. Injured WM demonstrates T2*WI hyperintensity but requires normalization for quantitative use. We introduce T2*WI WM/GM signal-intensity ratio and compare it against cross-sectional area, the DTI metric fractional anisotropy, and magnetization transfer ratio in degenerative cervical myelopathy.

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Magnetic Resonance Diffusion Tensor Imaging in Patients With Cervical Spondylotic Spinal Cord Compression

Abstract: The DTI appears to be a promising imaging modality in patients with spondylotic spinal cord compression. It reflects the presence of symptomatic myelopathy and shows considerable potential for discriminating between symptomatic and asymptomatic patients.

Cited by 100 publications

References 43 publications

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

Chronic Cervical Spinal Cord Injury: DTI Correlates with Clinical and Electrophysiological Measures

A Novel MRI Biomarker of Spinal Cord White Matter Injury: T2*-Weighted White Matter to Gray Matter Signal Intensity Ratio

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