Correlation Between Diffusion Tensor Imaging Parameters and Clinical Assessments in Patients with Cervical Spondylotic Myelopathy with and Without High Signal Intensity

Overview

Journal Spinal Cord

Specialty Neurology

Date 2017 Sep 6

PMID 28872149

Citations 3

Authors

Y Liu

C Kong

L Cui

X Yuan

P Zhao

Y Zhang

Y Guan

X Chen

Affiliations

Soon will be listed here.

Abstract

Study Design: A cross-sectional observational study.

Objectives: The aim of this study is to compare the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) between patients with cervical spondylotic myelopathy (CSM) with and without high T2-weighted signal intensity, and to correlate each parameter with clinical assessments.

Setting: CSM is a common cause of spinal cord dysfunction. The significance of T2 high signal intensity in the prognosis of CSM remains controversial.

Methods: Diffusion tensor imaging was performed at the cervical spinal cord in 40 patients with CSM and 42 healthy subjects. Patients with high signal intensity were separated from those without high signal intensity. ADC and FA values were compared among different groups, and the correlation between each parameter and the modified Japanese Orthopedic Association (mJOA) score was examined.

Results: The ADC and FA values of C2/3 differed significantly from those of C5/6 and C6/7 in healthy subjects. Patients with CSM had a higher ADC but a lower FA value than did healthy subjects. In all patients with CSM, there was a negative linear correlation between ADC and mJOA score, but FA value correlated positively with mJOA score. Secondary analysis suggested that FA value in patients with high signal intensity was lower than that in patients without high signal intensity. FA value showed a positive linear correlation with mJOA score in the patients with high signal intensity but not in the patients without high signal intensity.

Conclusions: Patients with high signal intensity may have more severe spinal cord injury than patients without high signal intensity, and FA may be a useful indicator of functional status in patients with CSM with high signal intensity.

Citing Articles

Acute Magnetic Resonance Imaging Predictors of Chronic Motor Function and Tissue Sparing in Rat Cervical Spinal Cord Injury.

Lee S, Schmit B, Kurpad S, Budde M J Neurotrauma. 2022; 39(23-24):1727-1740.

PMID: 35708112 PMC: 9734017. DOI: 10.1089/neu.2022.0034.

Quantitative Evaluation of the Diffusion Tensor Imaging Matrix Parameters and the Subsequent Correlation with the Clinical Assessment of Disease Severity in Cervical Spondylotic Myelopathy.

Nischal N, Tripathi S, Singh J Asian Spine J. 2020; 15(6):808-816.

PMID: 33189108 PMC: 8696054. DOI: 10.31616/asj.2020.0223.

Diffusion Tensor Imaging in Diagnosis of Post-Traumatic Syringomyelia in Spinal Cord Injury in Rats.

Zhang C, Chen K, Han X, Fu J, Douglas P, Morozova A Med Sci Monit. 2018; 24:177-182.

PMID: 29311540 PMC: 5771161. DOI: 10.12659/msm.907955.

References

Jones J, Cen S, Lebel R, Hsieh P, Law M . Diffusion tensor imaging correlates with the clinical assessment of disease severity in cervical spondylotic myelopathy and predicts outcome following surgery. AJNR Am J Neuroradiol. 2012; 34(2):471-8. PMC: 7965104. DOI: 10.3174/ajnr.A3199. View

Kelley B, Harel N, Kim C, Papademetris X, Coman D, Wang X . Diffusion tensor imaging as a predictor of locomotor function after experimental spinal cord injury and recovery. J Neurotrauma. 2014; 31(15):1362-73. PMC: 4120934. DOI: 10.1089/neu.2013.3238. View

Budzik J, Balbi V, Le Thuc V, Duhamel A, Assaker R, Cotten A . Diffusion tensor imaging and fibre tracking in cervical spondylotic myelopathy. Eur Radiol. 2010; 21(2):426-33. DOI: 10.1007/s00330-010-1927-z. View

Uchida K, Nakajima H, Takeura N, Yayama T, Guerrero A, Yoshida A . Prognostic value of changes in spinal cord signal intensity on magnetic resonance imaging in patients with cervical compressive myelopathy. Spine J. 2014; 14(8):1601-10. DOI: 10.1016/j.spinee.2013.09.038. View

Suri A, Chabbra R, Mehta V, Gaikwad S, Pandey R . Effect of intramedullary signal changes on the surgical outcome of patients with cervical spondylotic myelopathy. Spine J. 2003; 3(1):33-45. DOI: 10.1016/s1529-9430(02)00448-5. View

Al-Mefty O, Harkey H, Marawi I, Haines D, Peeler D, Wilner H . Experimental chronic compressive cervical myelopathy. J Neurosurg. 1993; 79(4):550-61. DOI: 10.3171/jns.1993.79.4.0550. View

Chen C, Lyu R, Lee S, Wong Y, Wang L . Intramedullary high signal intensity on T2-weighted MR images in cervical spondylotic myelopathy: prediction of prognosis with type of intensity. Radiology. 2001; 221(3):789-94. DOI: 10.1148/radiol.2213010365. View

Hirabayashi K, Miyakawa J, Satomi K, Maruyama T, Wakano K . Operative results and postoperative progression of ossification among patients with ossification of cervical posterior longitudinal ligament. Spine (Phila Pa 1976). 1981; 6(4):354-64. DOI: 10.1097/00007632-198107000-00005. View

Alafifi T, Kern R, Fehlings M . Clinical and MRI predictors of outcome after surgical intervention for cervical spondylotic myelopathy. J Neuroimaging. 2007; 17(4):315-22. DOI: 10.1111/j.1552-6569.2007.00119.x. View

10.

Naderi S, Ozgen S, Pamir M, Ozek M, Erzen C . Cervical spondylotic myelopathy: surgical results and factors affecting prognosis. Neurosurgery. 1998; 43(1):43-9; discussion 49-50. DOI: 10.1097/00006123-199807000-00028. View

11.

Vedantam A, Eckardt G, Wang M, Schmit B, Kurpad S . Clinical correlates of high cervical fractional anisotropy in acute cervical spinal cord injury. World Neurosurg. 2013; 83(5):824-8. DOI: 10.1016/j.wneu.2013.09.017. View

12.

Wen C, Cui J, Liu H, Mak K, Cheung W, Luk K . Is diffusion anisotropy a biomarker for disease severity and surgical prognosis of cervical spondylotic myelopathy?. Radiology. 2013; 270(1):197-204. DOI: 10.1148/radiol.13121885. View

13.

Ohshio I, Hatayama A, Kaneda K, Takahara M, Nagashima K . Correlation between histopathologic features and magnetic resonance images of spinal cord lesions. Spine (Phila Pa 1976). 1993; 18(9):1140-9. DOI: 10.1097/00007632-199307000-00005. View

14.

Zhang P, Shen Y, Zhang Y, Ding W, Wang L . Significance of increased signal intensity on MRI in prognosis after surgical intervention for cervical spondylotic myelopathy. J Clin Neurosci. 2011; 18(8):1080-3. DOI: 10.1016/j.jocn.2010.12.023. View

15.

Yukawa Y, Kato F, Yoshihara H, Yanase M, Ito K . MR T2 image classification in cervical compression myelopathy: predictor of surgical outcomes. Spine (Phila Pa 1976). 2007; 32(15):1675-8. DOI: 10.1097/BRS.0b013e318074d62e. View

16.

Holly L, Matz P, Anderson P, Groff M, Heary R, Kaiser M . Clinical prognostic indicators of surgical outcome in cervical spondylotic myelopathy. J Neurosurg Spine. 2009; 11(2):112-8. DOI: 10.3171/2009.1.SPINE08718. View

17.

Staempfli P, Reischauer C, Jaermann T, Valavanis A, Kollias S, Boesiger P . Combining fMRI and DTI: a framework for exploring the limits of fMRI-guided DTI fiber tracking and for verifying DTI-based fiber tractography results. Neuroimage. 2007; 39(1):119-26. DOI: 10.1016/j.neuroimage.2007.08.025. View

18.

Avadhani A, Rajasekaran S, Shetty A . Comparison of prognostic value of different MRI classifications of signal intensity change in cervical spondylotic myelopathy. Spine J. 2010; 10(6):475-85. DOI: 10.1016/j.spinee.2010.03.024. View

19.

Al-Mefty O, Harkey L, Middleton T, Smith R, Fox J . Myelopathic cervical spondylotic lesions demonstrated by magnetic resonance imaging. J Neurosurg. 1988; 68(2):217-22. DOI: 10.3171/jns.1988.68.2.0217. View

20.

Mastronardi L, ELsawaf A, Roperto R, Bozzao A, Caroli M, Ferrante M . Prognostic relevance of the postoperative evolution of intramedullary spinal cord changes in signal intensity on magnetic resonance imaging after anterior decompression for cervical spondylotic myelopathy. J Neurosurg Spine. 2007; 7(6):615-22. DOI: 10.3171/SPI-07/12/615. View