MR T2 Image Classification in Cervical Compression Myelopathy

Yukawa, Yasutsugu; Kato, Fumihiko; Yoshihara, Hisatake; Yanase, Makoto; Ito, Keigo

doi:10.1097/brs.0b013e318074d62e

Cited by 183 publications

(134 citation statements)

References 8 publications

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“…Statistical analysis showed significant difference in recovery rates between different grades of T2 signal intensity changes. Recovery rate decreased significantly grade 0 to grade 2.These data were consistent with the study Yasutsugu et al 11 .…”

Section: Discussionsupporting

confidence: 82%

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MRI Signal Intensity Changes in Cervical Spondylotic Myelopathy and Its Role in Assessing the Surgical Prognosis

Jacob¹

2017

JMSCR

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Section: Discussionsupporting

confidence: 82%

“…Statistical analysis showed significant difference in preoperative mJOA score between these groups. In the study by Yasutsugu et al 11 , there was no significant difference in the preoperative score between different grades of T2 signal intensity changes. Mean postoperative JOA score was 13.…”

Section: Discussionmentioning

confidence: 99%

MRI Signal Intensity Changes in Cervical Spondylotic Myelopathy and Its Role in Assessing the Surgical Prognosis

Jacob¹

2017

JMSCR

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“…13,16,17 However, contrary to expectation, there was no existence of statistically significant correlation (P = 0.067) between GSI and TA preoperatively. The reasons for this result could be resulted from strong influence of other variance such as age, differences in populations, site of compression and duration of symptoms.…”

Section: Discusioncontrasting

confidence: 48%

Quantitative magnetic resonance imaging analysis correlates with surgical outcome of cervical spondylotic myelopathy

Wang

et al. 2014

Spinal Cord

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Study design: Prospective study. Objectives: To investigate whether preoperative and postoperative changes of signal intensity (SI) and transverse area (TA) of the spinal cord reflect the surgical outcome in patients with cervical spondylotic myelopathy (CSM). Setting: The Second Hospital of Tangshan, Tangshan, Hebei, China. Methods: In 45 consecutive prospective patients, magnetic resonance imaging (MRI) was performed preoperatively and 3 months postoperatively. The Japanese Orthopedic Association (JOA) scale was used to quantify the neurological status at admission and of at least 12-month follow-up. Preoperative and postoperative TA of the spinal cord at the site of maximal compression and grayscale of signal intensity (GSI) were measured using the image analysis software. Ratio of transverse area (RTA) and ratio of grayscale of signal intensity (RGSI) were used to assess the extent of spinal cord re-expansion and extent of SI regression. Preoperative status and postoperative recovery were assessed in relation to MRI parameters preoperatively and postoperatively using univariate and multivariate analysis. Results: Higher baseline JOA scores were associated with larger TA. Greater recovery rate was associated with larger preoperative and postoperative TA, along with greater RTA. Recovery rate negatively correlated with RGSI and age. Higher baseline JOA score was associated with greater recovery rate. RGSI negatively correlated with RTA. Multivariate stepwise regression analysis showed that the optimal combination of surgical outcome predictors included age, postoperative TA and RGSI. 1 The natural history of CSM is progressive neurological deterioration in the majority of patients. The surgical intervention have been advocated to alter the natural history and improve the prognosis of patients with CSM. How to predict neurological outcomes after surgery is of great importance for the management of CSM patients. Various factors that may influence the surgical outcome include the patient's age, duration of myelopathic symptoms, baseline neurological status, preoperative signal changes on magnetic resonance images and TA of the spinal cord. [2][3][4][5] There is no doubt that magnetic resonance imaging (MRI) is the best radiological modality for examination and evaluation of patients with CSM. MRI can show not only the etiology of myelopathy but also the intramedullary state of the spinal cord in detail, 6,7 thereby helping in both the diagnosis and prognosis of CSM. 8,9 To date, postoperative MRI has not yet been fully studied in relation to the correlation of morphology or signal change of cervical cord and longer-term prognosis in CSM patients. In our study, we have focused on quantitative analysis of signal intensity (SI) and transverse area (TA) of the spinal cord on T2-weighted MRI preoperatively and postoperatively. The purpose of the present study was to investigate

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“…It has been reported that those signal intensity changes are associated with a poor neurological prognosis after decompression surgery for CSM. [12][13][14][15] On the other hand, Tauchi et al 16 recently reported that the MRI findings of the spinal cord were not associated with the surgical outcome in CSA patients, and they speculated that the compression or damage in the cervical spine was localized in the anterior horn of the spinal cord or the ventral nerve root in affected CSA patients, although it exists in the central portion of the spinal cord in most CSM patients. In the present study, we investigated the association between the signal intensity changes of the spinal cord on T2-weighted MR images and the neurological prognosis not only at the final observational follow-up, but also at the final follow-up after conversion to surgery, and we showed that CSA patients with high signal intensity changes on T2-weighted MRI had a poorer neurological prognosis compared with those without the high signal intensity change, although no significant difference was noted when the analysis was limited to the patients who required conversion to surgery.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors for cervical spondylotic amyotrophy: are signs of spinal cord involvement associated with the neurological prognosis?

Iizuka

Mieda

et al. 2014

Spinal Cord

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Objectives: The purpose of this study was to clarify the prognostic factors for cervical spondylotic amyotrophy (CSA). Methods: The authors retrospectively reviewed the medical records of 47 consecutive patients with CSA in whom the presence/ absence of the pyramidal tract sign was noted. We analyzed whether the age, sex, presence of diabetes mellitus, medication (vitamin B12), type of the most atrophic and impaired muscle, the muscle strength at the presentation, the presence of the pyramidal tract sign, magnetic resonance imaging (MRI) findings, including the presence and number of T2 high signal intensity areas (T2 HIA) in the spinal cord and the conversion to surgery were associated with the recovery of muscle strength in the patients. In addition, we also investigated whether the duration of symptoms before surgery and the type of surgery were associated with the recovery of muscle strength in patients who required conversion to surgical treatment. Results: The presence of T2 HIA on MRI (P ¼ 0.002), the number of T2 HIA on MRI (P ¼ 0.002) and conversion to surgery (P ¼ 0.015) were found to be significantly associated with a poorer recovery at the observational final follow-up. Further, the presence of the pyramidal tract sign (P ¼ 0.043) was significantly associated with a poor recovery at the final follow-up after surgery. Conclusion: The presence of a high signal intensity change on T2-weighted MRI and the pyramidal tract sign can be used as prognostic factors for patients with CSA.

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MR T2 Image Classification in Cervical Compression Myelopathy

Abstract: Preoperative ISI on T2-weighted sagittal MRI was correlated with patient age, duration of disease, postoperative JOA score, and postoperative recovery rate. Patients with the greatest ISI had the worst postop erative recovery. Classification of ISI can be a predictor of surgical outcome.

Cited by 183 publications

References 8 publications

MRI Signal Intensity Changes in Cervical Spondylotic Myelopathy and Its Role in Assessing the Surgical Prognosis

MRI Signal Intensity Changes in Cervical Spondylotic Myelopathy and Its Role in Assessing the Surgical Prognosis

Quantitative magnetic resonance imaging analysis correlates with surgical outcome of cervical spondylotic myelopathy

Prognostic factors for cervical spondylotic amyotrophy: are signs of spinal cord involvement associated with the neurological prognosis?

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