Characterization and limitations of diffusion tensor imaging metrics in the cervical spinal cord in neurologically intact subjects

Vedantam, Aditya; Jirjis, Michael B.; Schmit, Brian D.; Wang, Marjorie C.; Ulmer, John L.; Kurpad, Shekar N.

doi:10.1002/jmri.24039

Cited by 40 publications

(33 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We observed that the FA and ADC values indicated significant differences between GM and individual WM funiculi. These data are supported by previous studies [1,21]. In addition, we found that there were significant differences in the FA and ADC values of the different WM funiculi at different CSC segments, but that there were no differences in the DTI parameters of the GM from different CSC segments, an analysis that was not performed by Vedantam et al Compared with the upper and middle segments, both FA and ADC values from WM funiculis of lower segments were lower.…”

Section: Discussionsupporting

confidence: 86%

“…In addition, we found that there were significant differences in the FA and ADC values of the different WM funiculi at different CSC segments, but that there were no differences in the DTI parameters of the GM from different CSC segments, an analysis that was not performed by Vedantam et al Compared with the upper and middle segments, both FA and ADC values from WM funiculis of lower segments were lower. These results could be due to the decreased spinal cord volume of the lower segments, or to differences in signal-to-noise ratio (SNR) across the cervical segments [1,11,21].…”

Section: Discussionmentioning

confidence: 93%

“…The FA of the CSC has been shown to decrease with age [12,13,21]. In 2005, Mamata et al [13] showed in subjects aged 26-82 years that ADC values increased with increasing age, while FA decreased.…”

Section: Discussionmentioning

confidence: 96%

“…To the best of our knowledge, only one study [21] assessed the normal DTI parameters of the whole CSC. Indeed, Vedantam et al [21] characterized the DTI parameters of the GM and individual WM funiculi across all levels of the CSC in a sample of neurologically intact subjects (age range of 22-85 years).…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, Vedantam et al [21] characterized the DTI parameters of the GM and individual WM funiculi across all levels of the CSC in a sample of neurologically intact subjects (age range of 22-85 years). They showed that the FA and ADC values were significantly different between GM and WM funiculi.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Age-related changes of the diffusion tensor imaging parameters of the normal cervical spinal cord

Wang

Song

Fan

et al. 2014

European Journal of Radiology

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Age-related changes of the diffusion tensor imaging parameters of the normal cervical spinal cord

Wang

Song

Fan

et al. 2014

European Journal of Radiology

View full text Add to dashboard Cite

Tract-specific and age-related variations of the spinal cord microstructure: a multi-parametric MRI study using diffusion tensor imaging (DTI) and inhomogeneous magnetization transfer (ihMT)

et al. 2016

View full text Add to dashboard Cite

Being able to finely characterize the spinal cord (SC) microstructure and its alterations is a key point when investigating neural damage mechanisms encountered in different central nervous system (CNS) pathologies, such as multiple sclerosis, amyotrophic lateral sclerosis or myelopathy. Based on novel methods, including inhomogeneous magnetization transfer (ihMT) and dedicated SC probabilistic atlas post-processing, the present study focuses on the in vivo characterization of the healthy SC tissue in terms of regional microstructure differences between (i) upper and lower cervical vertebral levels and (ii) sensory and motor tracts, as well as differences attributed to normal aging. Forty-eight healthy volunteers aged from 20 to 70 years old were included in the study and scanned at 3 T using axial high-resolution T2 *-w imaging, diffusion tensor imaging (DTI) and ihMT, at two vertebral levels (C2 and C5). A processing pipeline with minimal user intervention, SC segmentation and spatial normalization into a reference space was implemented in order to assess quantitative morphological and structural parameters (cross-sectional areas, scalar DTI and MT/ihMT metrics) in specific white and gray matter regions of interest. The multi-parametric MRI metrics collected allowed upper and lower cervical levels to be distinguished, with higher ihMT ratio (ihMTR), higher axial diffusivity (λ∥ ) and lower radial diffusivity (λ⊥ ) at C2 compared with C5. Significant differences were also observed between white matter fascicles, with higher ihMTR and lower λ∥ in motor tracts compared with posterior sensory tracts. Finally, aging was found to be associated with significant metric alterations (decreased ihMTR and λ∥ ). The methodology proposed here, which can be easily transferred to the clinic, provides new insights for SC characterization. It bears great potential to study focal and diffuse SC damage in neurodegenerative and demyelinating diseases. Copyright © 2016 John Wiley & Sons, Ltd.

show abstract

High‐resolution diffusion tensor imaging in cervical spondylotic myelopathy: a preliminary follow‐up study

et al. 2017

View full text Add to dashboard Cite

Diffusion imaging is a promising technique as it can provide microstructural tissue information and thus potentially show viable changes in spinal cord. However, the traditional single-shot imaging method is limited as a result of various image artifacts. In order to improve measurement accuracy, we used a newly developed, multi-shot, high-resolution, diffusion tensor imaging (DTI) method to investigate diffusion metric changes and compare them with T -weighted (T2W) images before and after decompressive surgery for cervical spondylotic myelopathy (CSM). T2W imaging, single-shot DTI and multi-shot DTI were employed to scan seven patients with CSM before and 3 months after decompressive surgery. High signal intensities were scored using the T2 W images. DTI metrics, including fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD), were quantified and compared pre- and post-surgery. In addition, the relationship between imaging metrics and neurological assessments was examined. The reproducibility of multi-shot DTI was also assessed in 10 healthy volunteers. Post-surgery, the mean grade of cervical canal stenosis was reduced from grade 3 to normal after 3 months. Compared with single-shot DTI, multi-shot DTI provided better images with lower artifact levels, especially following surgery, as a result of reduced artifacts from metal implants. The new method also showed acceptable reproducibility. Both FA and RD values from the new acquisition showed significant differences post-surgery (FA, p = 0.026; RD, p = 0.048). These changes were consistent with neurological assessments. In contrast, T2W images did not show significant changes before and after surgery. Multi-shot diffusion imaging showed improved image quality over single-shot DWI, and presented superior performance in diagnosis and recovery monitoring for patients with CSM compared with T2W imaging. DTI metrics can reflect the pathological conditions of spondylotic spinal cord quantitatively and may serve as a sensitive biomarker for potential CSM management.

show abstract

Characterization and limitations of diffusion tensor imaging metrics in the cervical spinal cord in neurologically intact subjects

Abstract: This study provides DTI data for GM and WM funiculi throughout the CSC. While DTI metrics may be used to define cord pathology, variations in metrics due to age and signal quality need to be accounted for before making definitive conclusions.

Cited by 40 publications

References 35 publications

Age-related changes of the diffusion tensor imaging parameters of the normal cervical spinal cord

Age-related changes of the diffusion tensor imaging parameters of the normal cervical spinal cord

Tract-specific and age-related variations of the spinal cord microstructure: a multi-parametric MRI study using diffusion tensor imaging (DTI) and inhomogeneous magnetization transfer (ihMT)

High‐resolution diffusion tensor imaging in cervical spondylotic myelopathy: a preliminary follow‐up study

Contact Info

Product

Resources

About