Decreased Value of Highly Accurate Fractional Anisotropy Using 3-Tesla ZOOM Diffusion Tensor Imaging After Decompressive Surgery in Patients with Cervical Spondylotic Myelopathy: Aligned Fibers Effect
Background: Diffusion tensor imaging (DTI) is widely used; however, most of the prior studies have resulted in presurgical decreased fractional anisotropy (FA) values in patients with cervical spondylotic myelopathy (CSM). We used ZOOM DTI and could acquire highly accurate FA values during periopera...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2019-10-01
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| Series: | World Neurosurgery: X |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590139719300973 |
| _version_ | 1828486577111695360 |
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| author | Motoyuki Iwasaki Takumi Yokohama Daisuke Oura Shou Furuya Yoshimasa Niiya Tomoyuki Okuaki |
| author_facet | Motoyuki Iwasaki Takumi Yokohama Daisuke Oura Shou Furuya Yoshimasa Niiya Tomoyuki Okuaki |
| author_sort | Motoyuki Iwasaki |
| collection | DOAJ |
| description | Background: Diffusion tensor imaging (DTI) is widely used; however, most of the prior studies have resulted in presurgical decreased fractional anisotropy (FA) values in patients with cervical spondylotic myelopathy (CSM). We used ZOOM DTI and could acquire highly accurate FA values during perioperative periods, which indicated different insights than preceding studies. The objective of this study was to assess the perioperative FA change in patients with CSM and determine the prognostic factor. Methods: Twenty-eight patients with CSM and healthy control subjects were enrolled in this study. Twenty patients (71%) had intracordal high intensity before surgery. All patients underwent decompressive surgery. ZOOM DTI and the Japanese Orthopaedic Association (JOA) assessment were performed before and after surgery. The region of interest was manually contoured to omit the surrounding cerebrospinal fluid. The axial plane of the most stenotic cervical level was assessed. Results: FA values before surgery and at 1 week after surgery, and FA values at 1 week after surgery and at 6 months after surgery differed significantly as determined. The FA values of patients with intracordal high intensity significantly decreased after surgery and significantly increased from 1 week to 6 months, whereas those of patients without intracordal high intensity did not significantly change. JOA scores at 6 months after surgery (13.1) improved significantly compared with JOA scores before surgery (10.8). Only FA values at 1 week after surgery had a significant positive relationship with JOA scores presurgery and at 6 months after surgery. Conclusions: The presurgical FA value in patients with CSM did not differ from that of normal control subjects, but significantly decreased after surgery, and significantly increased 6 months after surgery. We concluded that the postsurgical FA value approximates the proper state of the damaged cord and the presurgical FA value includes a masked effect as an aligned fiber effect because of compression by degenerative construction. Only the FA value at 1 week had a significant positive relationship with the JOA score presugery and at 6 months, which established that the postsurgical FA value may be a more accurate prognostic factor than the presurgical FA value. Key words: Cervical degenerative spondylosis, Diffusion tensor imaging, Fractional anisotropy, Prognostic factor, Tractography |
| first_indexed | 2024-12-11T09:35:27Z |
| format | Article |
| id | doaj.art-8873a48a0c2f42938110b0898469ecdc |
| institution | Directory Open Access Journal |
| issn | 2590-1397 |
| language | English |
| last_indexed | 2024-12-11T09:35:27Z |
| publishDate | 2019-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | World Neurosurgery: X |
| spelling | doaj.art-8873a48a0c2f42938110b0898469ecdc2022-12-22T01:12:53ZengElsevierWorld Neurosurgery: X2590-13972019-10-014Decreased Value of Highly Accurate Fractional Anisotropy Using 3-Tesla ZOOM Diffusion Tensor Imaging After Decompressive Surgery in Patients with Cervical Spondylotic Myelopathy: Aligned Fibers EffectMotoyuki Iwasaki0Takumi Yokohama1Daisuke Oura2Shou Furuya3Yoshimasa Niiya4Tomoyuki Okuaki5Department of Neurosurgery, Otaru General Hospital, Otaru, Hokkaido, Japan; To whom correspondence should be addressed: Motoyuki Iwasaki, M.D., Ph.D.Department of Radiology, Otaru General Hospital, Otaru, Hokkaido, JapanDepartment of Radiology, Otaru General Hospital, Otaru, Hokkaido, JapanDepartment of Neurosurgery, Otaru General Hospital, Otaru, Hokkaido, JapanDepartment of Neurosurgery, Otaru General Hospital, Otaru, Hokkaido, JapanDepartment of Radiology, Philips Healthcare, Minato-Ku, Tokyo, JapanBackground: Diffusion tensor imaging (DTI) is widely used; however, most of the prior studies have resulted in presurgical decreased fractional anisotropy (FA) values in patients with cervical spondylotic myelopathy (CSM). We used ZOOM DTI and could acquire highly accurate FA values during perioperative periods, which indicated different insights than preceding studies. The objective of this study was to assess the perioperative FA change in patients with CSM and determine the prognostic factor. Methods: Twenty-eight patients with CSM and healthy control subjects were enrolled in this study. Twenty patients (71%) had intracordal high intensity before surgery. All patients underwent decompressive surgery. ZOOM DTI and the Japanese Orthopaedic Association (JOA) assessment were performed before and after surgery. The region of interest was manually contoured to omit the surrounding cerebrospinal fluid. The axial plane of the most stenotic cervical level was assessed. Results: FA values before surgery and at 1 week after surgery, and FA values at 1 week after surgery and at 6 months after surgery differed significantly as determined. The FA values of patients with intracordal high intensity significantly decreased after surgery and significantly increased from 1 week to 6 months, whereas those of patients without intracordal high intensity did not significantly change. JOA scores at 6 months after surgery (13.1) improved significantly compared with JOA scores before surgery (10.8). Only FA values at 1 week after surgery had a significant positive relationship with JOA scores presurgery and at 6 months after surgery. Conclusions: The presurgical FA value in patients with CSM did not differ from that of normal control subjects, but significantly decreased after surgery, and significantly increased 6 months after surgery. We concluded that the postsurgical FA value approximates the proper state of the damaged cord and the presurgical FA value includes a masked effect as an aligned fiber effect because of compression by degenerative construction. Only the FA value at 1 week had a significant positive relationship with the JOA score presugery and at 6 months, which established that the postsurgical FA value may be a more accurate prognostic factor than the presurgical FA value. Key words: Cervical degenerative spondylosis, Diffusion tensor imaging, Fractional anisotropy, Prognostic factor, Tractographyhttp://www.sciencedirect.com/science/article/pii/S2590139719300973 |
| spellingShingle | Motoyuki Iwasaki Takumi Yokohama Daisuke Oura Shou Furuya Yoshimasa Niiya Tomoyuki Okuaki Decreased Value of Highly Accurate Fractional Anisotropy Using 3-Tesla ZOOM Diffusion Tensor Imaging After Decompressive Surgery in Patients with Cervical Spondylotic Myelopathy: Aligned Fibers Effect World Neurosurgery: X |
| title | Decreased Value of Highly Accurate Fractional Anisotropy Using 3-Tesla ZOOM Diffusion Tensor Imaging After Decompressive Surgery in Patients with Cervical Spondylotic Myelopathy: Aligned Fibers Effect |
| title_full | Decreased Value of Highly Accurate Fractional Anisotropy Using 3-Tesla ZOOM Diffusion Tensor Imaging After Decompressive Surgery in Patients with Cervical Spondylotic Myelopathy: Aligned Fibers Effect |
| title_fullStr | Decreased Value of Highly Accurate Fractional Anisotropy Using 3-Tesla ZOOM Diffusion Tensor Imaging After Decompressive Surgery in Patients with Cervical Spondylotic Myelopathy: Aligned Fibers Effect |
| title_full_unstemmed | Decreased Value of Highly Accurate Fractional Anisotropy Using 3-Tesla ZOOM Diffusion Tensor Imaging After Decompressive Surgery in Patients with Cervical Spondylotic Myelopathy: Aligned Fibers Effect |
| title_short | Decreased Value of Highly Accurate Fractional Anisotropy Using 3-Tesla ZOOM Diffusion Tensor Imaging After Decompressive Surgery in Patients with Cervical Spondylotic Myelopathy: Aligned Fibers Effect |
| title_sort | decreased value of highly accurate fractional anisotropy using 3 tesla zoom diffusion tensor imaging after decompressive surgery in patients with cervical spondylotic myelopathy aligned fibers effect |
| url | http://www.sciencedirect.com/science/article/pii/S2590139719300973 |
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