Quantitative Evaluation of the Diffusion Tensor Imaging Matrix Parameters and the Subsequent Correlation with the Clinical Assessment of Disease Severity in Cervical Spondylotic Myelopathy
Study Design We performed a prospective observational study of 52 patients who were clinically suspected of cervical spondylotic myelopathy (CSM), based on the modified Japanese Orthopaedic Association (mJOA) score, and were referred for magnetic resonance imaging (MRI) of the cervical spine. Purpos...
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| Format: | Article |
| Language: | English |
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Korean Spine Society
2021-12-01
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| Series: | Asian Spine Journal |
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| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-2020-0223.pdf |
| _version_ | 1818974828355387392 |
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| author | Neha Nischal Shalini Tripathi Jatinder Pal Singh |
| author_facet | Neha Nischal Shalini Tripathi Jatinder Pal Singh |
| author_sort | Neha Nischal |
| collection | DOAJ |
| description | Study Design We performed a prospective observational study of 52 patients who were clinically suspected of cervical spondylotic myelopathy (CSM), based on the modified Japanese Orthopaedic Association (mJOA) score, and were referred for magnetic resonance imaging (MRI) of the cervical spine. Purpose To evaluate the quantitative parameters of the diffusion tensor imaging (DTI) matrix (fractional anisotropy [FA] and apparent diffusion coefficient [ADC] values) and determine the subsequent correlation with the clinical assessment of disease severity in CSM. Overview of Literature Conventional MRI is the modality of choice for the identification of cervical spondylotic changes and is known to have a low sensitivity for myelopathy changes. DTI is sensitive to disease processes that alter the water movement in the cervical spinal cord at a microscopic level beyond the conventional MRI. Methods DTI images were processed to produce FA and ADC values of the acquired axial slices with the regions of interest placed within the stenotic and non-stenotic segments. The final quantitative radiological derivations were matched with the clinical scoring system. Results Total 52 people (24 men and 28 women), mean age 53.16 years with different symptoms of myelopathy, graded as mild (n=11), moderate (n=25), and severe (n=16) as per the mJOA scoring system, underwent MRI of the cervical spine with DTI. In the most stenotic segments, the mean FA value was significantly lower (0.5009±0.087 vs. 0.655.7±0.104, p<0.001), and the mean ADC value was significantly higher (1.196.5±0.311 vs. 0.9370±0.284, p<0.001) than that in the non-stenotic segments. The overall sensitivity in identifying DTI metrics abnormalities was more with FA (87.5%) and ADC (75.0%) than with T2 weighted images (25%). Conclusions In addition to the routine MRI sequences, DTI metrics (FA value better than ADC) can detect myelopathy even in patients with a mild grade mJOA score before irreversible changes become apparent on routine T2 weighted imaging and thus enhance the clinical success of decompression surgery. |
| first_indexed | 2024-12-20T15:46:15Z |
| format | Article |
| id | doaj.art-3feb611c04554159bdbc55a101e53ab9 |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-12-20T15:46:15Z |
| publishDate | 2021-12-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-3feb611c04554159bdbc55a101e53ab92022-12-21T19:34:56ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462021-12-0115680881610.31616/asj.2020.02231299Quantitative Evaluation of the Diffusion Tensor Imaging Matrix Parameters and the Subsequent Correlation with the Clinical Assessment of Disease Severity in Cervical Spondylotic MyelopathyNeha Nischal0Shalini Tripathi1Jatinder Pal Singh2Department of Radiology, Medanta-The Medicity, Gurugram, IndiaDepartment of Radiology, Medanta-The Medicity, Gurugram, IndiaDepartment of Radiology, Medanta-The Medicity, Gurugram, IndiaStudy Design We performed a prospective observational study of 52 patients who were clinically suspected of cervical spondylotic myelopathy (CSM), based on the modified Japanese Orthopaedic Association (mJOA) score, and were referred for magnetic resonance imaging (MRI) of the cervical spine. Purpose To evaluate the quantitative parameters of the diffusion tensor imaging (DTI) matrix (fractional anisotropy [FA] and apparent diffusion coefficient [ADC] values) and determine the subsequent correlation with the clinical assessment of disease severity in CSM. Overview of Literature Conventional MRI is the modality of choice for the identification of cervical spondylotic changes and is known to have a low sensitivity for myelopathy changes. DTI is sensitive to disease processes that alter the water movement in the cervical spinal cord at a microscopic level beyond the conventional MRI. Methods DTI images were processed to produce FA and ADC values of the acquired axial slices with the regions of interest placed within the stenotic and non-stenotic segments. The final quantitative radiological derivations were matched with the clinical scoring system. Results Total 52 people (24 men and 28 women), mean age 53.16 years with different symptoms of myelopathy, graded as mild (n=11), moderate (n=25), and severe (n=16) as per the mJOA scoring system, underwent MRI of the cervical spine with DTI. In the most stenotic segments, the mean FA value was significantly lower (0.5009±0.087 vs. 0.655.7±0.104, p<0.001), and the mean ADC value was significantly higher (1.196.5±0.311 vs. 0.9370±0.284, p<0.001) than that in the non-stenotic segments. The overall sensitivity in identifying DTI metrics abnormalities was more with FA (87.5%) and ADC (75.0%) than with T2 weighted images (25%). Conclusions In addition to the routine MRI sequences, DTI metrics (FA value better than ADC) can detect myelopathy even in patients with a mild grade mJOA score before irreversible changes become apparent on routine T2 weighted imaging and thus enhance the clinical success of decompression surgery.http://www.asianspinejournal.org/upload/pdf/asj-2020-0223.pdfdiffusion tensor imagingcervical spondylosismyelopathyquantitative |
| spellingShingle | Neha Nischal Shalini Tripathi Jatinder Pal Singh Quantitative Evaluation of the Diffusion Tensor Imaging Matrix Parameters and the Subsequent Correlation with the Clinical Assessment of Disease Severity in Cervical Spondylotic Myelopathy Asian Spine Journal diffusion tensor imaging cervical spondylosis myelopathy quantitative |
| title | Quantitative Evaluation of the Diffusion Tensor Imaging Matrix Parameters and the Subsequent Correlation with the Clinical Assessment of Disease Severity in Cervical Spondylotic Myelopathy |
| title_full | Quantitative Evaluation of the Diffusion Tensor Imaging Matrix Parameters and the Subsequent Correlation with the Clinical Assessment of Disease Severity in Cervical Spondylotic Myelopathy |
| title_fullStr | Quantitative Evaluation of the Diffusion Tensor Imaging Matrix Parameters and the Subsequent Correlation with the Clinical Assessment of Disease Severity in Cervical Spondylotic Myelopathy |
| title_full_unstemmed | Quantitative Evaluation of the Diffusion Tensor Imaging Matrix Parameters and the Subsequent Correlation with the Clinical Assessment of Disease Severity in Cervical Spondylotic Myelopathy |
| title_short | Quantitative Evaluation of the Diffusion Tensor Imaging Matrix Parameters and the Subsequent Correlation with the Clinical Assessment of Disease Severity in Cervical Spondylotic Myelopathy |
| title_sort | quantitative evaluation of the diffusion tensor imaging matrix parameters and the subsequent correlation with the clinical assessment of disease severity in cervical spondylotic myelopathy |
| topic | diffusion tensor imaging cervical spondylosis myelopathy quantitative |
| url | http://www.asianspinejournal.org/upload/pdf/asj-2020-0223.pdf |
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