Diffusion tensor imaging and fibre tracking in cervical spondylotic myelopathy

Budzik, Jean-François; Balbi, V.; Thuc, Vianney Le; Duhamel, Alain; Assaker, R.; Cotten, Anne

doi:10.1007/s00330-010-1927-z

Cited by 125 publications

(132 citation statements)

References 30 publications

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“…Cerebrospinal fluid flow disturbances, resulting from degenerative changes both in static position and during movement, could increase the pressure around the spinal cord and, in turn, alter interstitial diffusion which would result in DTI metrics changes [6]. The differences in FA and ADC values between control group and groups representing advanced, degenerative changes (D, E) were obvious, and has been already described by many authors [1,[6][7][8][13][14][15].…”

Section: Discussionmentioning

confidence: 67%

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Usefulness of diffusion tensor MR imaging in the assessment of intramedullary changes of the cervical spinal cord in different stages of degenerative spine disease

et al. 2014

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Purpose The aim of this study was to evaluate the usefulness of diffusion tensor imaging (DTI) in the detection of cervical spinal cord integrity alterations in different stages of degenerative spine disease, as well as to compare DTI parameters with selected cervical spinal stenosis measurements. Methods One hundred and thirty-two symptomatic patients (mean age 53.58 years) with different stages of cervical spondylosis and twenty-five control subjects (mean age 45.78 years) were enrolled in the study. DTI was performed with a 1.5 T MR scanner. Three hundred and forty-nine spine segments from C2/C3 to C5/C6 were evaluated and divided into five groups according to the degree of spinal cord compression. The values of fractional anisotropy (FA) and apparent diffusion coefficient at each level were calculated and their correlations with the degree of stenosis were analyzed.Results FA values differed significantly (p \ 0.0001) at all levels between the control group and patients with cervical degenerative disease, including subjects without spinal cord compression visible on plain MR images. A significant (p \ 0.01) positive correlation between the mean FA values and anteroposterior diameter of the spinal canal as well as space available for the spinal cord index was demonstrated at all investigated levels. Conclusion DTI is capable of revealing impairment of the cervical spinal cord microstructure at the very early stage of degenerative spine disease, even prior to spinal cord compression visible on plain MR. Anteroposterior spinal canal diameter as well as space available for the cord index is well related to spinal cord tissue integrity defined by DTI.

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Section: Discussionmentioning

confidence: 67%

“…Therefore, DTI seems to be sensitive to pathological processes altering water diffusion at a microscopic level, far beyond the resolution of conventional MR imaging [13]. Several investigators have carried out DTI studies in patients suffering from CSM [1,[6][7][8][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Usefulness of diffusion tensor MR imaging in the assessment of intramedullary changes of the cervical spinal cord in different stages of degenerative spine disease

et al. 2014

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“…6 This raises the possibility of using DT imaging to distinguish patients with permanent myelopathic injury, reversible myelopathic injury, and absence of myelopathic change. Budzik et al 5 correlated mJOA scores with DT imaging results in 20 patients with CSM and found lower FA values in those with worse clinical function. The mean upper-and lower-extremity mJOA scores of 76.1 and 63.4, respectively, in this mildly affected population underscore the high sensitivity of DT imaging in detecting white matter damage.…”

Section: Clinical Application Of Dt Imagingmentioning

confidence: 99%

Diffusion tensor imaging in the assessment of ossification of the posterior longitudinal ligament: a report on preliminary results in 3 cases and review of the literature

Jones

Lerner

Kim

et al. 2011

FOC

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Cervical spondylotic myelopathy due to ossification of the posterior longitudinal ligament (OPLL) is a common neurosurgical disease that carries high morbidity. OPLL and other degenerative processes cause narrowing of the central canal, with subsequent spinal cord injury. Repeated minor trauma and vascular aberrations have been purported to underlie cervical spondylotic myelopathy, although the exact pathophysiological mechanism is unclear. Regardless, detection of early axonal damage may allow more timely surgical intervention and prediction of functional outcome. Diffusion tensor (DT) imaging of the cervical spine is a novel technique with improved sensitivity compared with conventional anatomical MR imaging that is currently available on most clinical scanners. This review describes the theoretical basis, application, and analysis of DT imaging as it pertains to neurosurgery. Particular emphasis is placed on OPLL.

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“…Recent developments in MR pulse sequence design have greatly reduced these problems (Thurnher and Law 2009;Wilm, Gamper et al 2009;Wilm, Svensson et al 2007). Clinical findings correlate with DTI metrics of the injured spinal cord (Budzik, Balbi et al 2011;Chang, Jung et al 2010;Kim, Loy et al 2010;Qian, Chan et al 2011). Few studies have explored the relationship between structural integrity, evaluated using DTI, and physiological function of the human spinal cord Kerkovsky, Bednarik et al 2011;Qian, Chan et al 2011).…”

Section: Introductionmentioning

confidence: 99%

Chronic Cervical Spinal Cord Injury: DTI Correlates with Clinical and Electrophysiological Measures

Petersen

Wilm

Meyenburg

et al. 2012

Journal of Neurotrauma

118

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Diffusion tensor imaging (DTI) is rarely applied in spinal cord injury (SCI). The aim of this study was to correlate diffusion properties after SCI with electrophysiological and neurological measures. Nineteen traumatic cervical SCI subjects and 28 age-matched healthy subjects participated in this study. DTI data of the spinal cord were acquired with a Philips Achieva 3 T MR scanner using an outer volume suppressed, reduced field of view (FOV) acquisition with oblique slice excitation and a single-shot EPI readout. Neurological and electrophysiological measures, American Spinal Injury Association (ASIA) impairment scale scores, and motor (MEP) and somatosensory evoked potentials (SSEP) were assessed in SCI subjects. Fractional anisotropy (FA) values were decreased in the SCI subjects compared to the healthy subjects. In upper cervical segments, the decrease in FA was significant for the evaluation of the entire cross-sectional area of the spinal cord, and for corticospinal and sensory tracts. A decreasing trend was also found at the thoracic level for the corticospinal tracts. The decrease of DTI values correlated with the clinical completeness of SCI, and with SSEP amplitudes. The reduced DTI values seen in the SCI subjects are likely due to demyelination and axonal degeneration of spinal tracts, which are related to clinical and electrophysiological measures. A reduction in DTI values in regions remote from the injury site suggests their involvement with wallerian axonal degeneration. DTI can be used for the quantitative evaluation of the extent of spinal cord damage, and eventually to monitor the effects of future regeneration-inducing treatments. This article has been peer-reviewed and accepted for publication, but has yet to undergo copyediting and proof correction. The final published version may differ from this proof. This article has been peer-reviewed and accepted for publication, but has yet to undergo copyediting and proof correction. The final published version may differ from this proof. Abstract

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Diffusion tensor imaging and fibre tracking in cervical spondylotic myelopathy

Abstract: FA values were significantly correlated with some of the patients' clinical scores. High signal intensity of the spinal cord on T2 was not correlated either with the DTI parameters or with the clinical assessment, suggesting that FA is more sensitive than T2 imaging.

Cited by 125 publications

References 30 publications

Usefulness of diffusion tensor MR imaging in the assessment of intramedullary changes of the cervical spinal cord in different stages of degenerative spine disease

Usefulness of diffusion tensor MR imaging in the assessment of intramedullary changes of the cervical spinal cord in different stages of degenerative spine disease

Diffusion tensor imaging in the assessment of ossification of the posterior longitudinal ligament: a report on preliminary results in 3 cases and review of the literature

Chronic Cervical Spinal Cord Injury: DTI Correlates with Clinical and Electrophysiological Measures

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