Diffusion-weighted MR Imaging with Apparent Diffusion Coefficient and Apparent Diffusion Tensor Maps in Cervical Spondylotic Myelopathy

Demir, Ayhan S.; Ries, Mario; Moonen, C.T.W.; Vital, Jean-Marc; Dehais, J.; Arné, Pierre; Caillé, J. M.; Dousset, V.

doi:10.1148/radiol.2291020658

Cited by 214 publications

(169 citation statements)

References 26 publications

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“…The DTI parameters measured in our control group were similar to previous measurements. 17 The SCI patients had abnormal FAs and ADCs at levels cranial and caudal to the site of injury. In contrast, conventional MRI showed no cord signal abnormalities.…”

Section: Evoked Potentialsmentioning

confidence: 94%

“…16 Long-term compression of the spinal cord can cause turbulence in CSF flow, allowing the CSF to penetrate the spinal cord and form intramedullary microcysts not detected by conventional MRI. 17 PC-MRI determinations of CSF flow have been used to detect Chiari malformations in the cisterna magna and hydrocephalus, which are regions with a relatively wide SAS in the cerebrospinal junction or cerebral aqueduct. [5][6][7] The pulsatility of the CSF, initially determined myelographically, is associated with choroid plexus pulsations and is modulated by the respiratory cycle.…”

Section: Evoked Potentialsmentioning

confidence: 99%

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Correlation of diffusion tensor imaging and phase-contrast MR with clinical parameters of cervical spinal cord injuries

Chang

et al. 2015

Spinal Cord

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Study design: This is a cross-sectional study. Objectives: The goal of this study was to characterize the diffusion properties across segments of the spinal cord and peak cerebrospinal fluid (CSF) velocities in the stenotic spinal canal, and to determine the correlation between these properties and clinical and electrophysiological parameters in patients with cervical spinal cord injury (SCI). Setting: This study was conducted in the University teaching hospital. Methods: The study involved 17 patients with cervical SCI. The apparent diffusion coefficient (ADC) and fractional anisotropy (FA) of the spinal cord and peak systolic and diastolic velocities of CSF were measured at the level of maximum compression (region 1) and at the levels above (region 2) and below (region 3) the level of injury with no signal change in conventional magnetic resonance imaging. Neurological and electrophysiological parameters were measured, including American Spinal Injury Association (ASIA) Impairment Scale (AIS), ASIA motor score, ASIA sensory score, Modified Barthel Index, Spinal Cord Independence Measure III (SCIM III), somatosensory evoked potentials (SSEP) and motor evoked potentials (MEP). Results: The ADC was significantly higher and the FA was significantly lower in regions 1, 2 and 3 of the SCI patients than in the normal controls (Po0.05 each). FA of the level below correlated with AIS, ASIA sensory score and SCIM III score, and FA of the level above correlated with SSEP latencies and MEP amplitudes (Po0.05 each). The reductions in FA correlated with CSF flow, functional measurements and evoked potentials. INTRODUCTIONOwing to its high soft-tissue resolution, conventional magnetic resonance imaging (MRI) is used routinely in the diagnosis of spinal cord injury (SCI). However, conventional MRI has low sensitivity for diffusion abnormalities in the white matter, limiting the associations between MRI results and clinical status. 1,2 Diffusion tensor imaging (DTI) with fiber tractography provides a threedimensional model of water diffusion for longitudinal evaluations of the central nervous system. 3 Although the application of DTI to the human spinal cord is challenging technically, owing to the small cross-sectional area of the spinal cord, cardiac and respiratory motion, and widely varying magnetic susceptibility, 4 recent developments in magnetic resonance (MR) pulse sequence design have greatly reduced these problems. Moreover, phase-contrast MRI (PC-MRI) is a noninvasive technique that can be used to quantify variations in the flow of the cerebrospinal fluid (CSF) gated with the cardiac cycle. 5 CSF flow can be influenced by stenotic lesions in the brain and spinal cord. 6,7 Initially, SCI results in the physical disruption of structures in the spinal cord (primary insult), and it might also induce secondary events that injure intact, neighboring tissues in the epidural, subdural,

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Section: Evoked Potentialsmentioning

confidence: 94%

Section: Evoked Potentialsmentioning

confidence: 99%

Correlation of diffusion tensor imaging and phase-contrast MR with clinical parameters of cervical spinal cord injuries

Chang

et al. 2015

Spinal Cord

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“…In our study, we have chosen to use manually defined ROIs, which is the method of choice in most DTI studies of the spinal cord. 3,8,10,12,14,22 Other methods of segmentation used in DTI analysis of the human spinal cord include thresholding the diffusion or anisotropy images 23 and fuzzy-logic-based tissue classification. 6,24 These methods seem to be sufficient; however, they may differ in their performance if diffusion characteristics change throughout the length of the cord.…”

Section: Data Description For Regions Of Interestmentioning

confidence: 99%

Diffusion Tensor MR Imaging of the Neurologically Intact Human Spinal Cord

Ellingson¹,

Ulmer²,

Kurpad³

et al. 2008

AJNR Am J Neuroradiol

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“…The most serious complication is spinal cord compression, resulting in neural tissue damage and a syndrome of spinal cord dysfunction known as cervical spondylotic myelopathy (CSM). Magnetic resonance imaging (MRI) is the modality of choice for quantifying the extent of degenerative alterations and spinal canal narrowing, though it has been proven to have low sensitivity in myelopathy detection, ranging 15-65 % [1][2][3][4][5][6]. Abnormal T2 signal intensity of the compressed spinal cord, which is considered to reflect myelopathic changes, is not always present, even in very advanced stages of clinically evident myelopathy, and poorly correlates with disease severity [7,8].…”

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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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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Diffusion-weighted MR Imaging with Apparent Diffusion Coefficient and Apparent Diffusion Tensor Maps in Cervical Spondylotic Myelopathy

Abstract: Diffusion weighting improved the sensitivity of imaging in cervical spondylotic myelopathy.

Cited by 214 publications

References 26 publications

Correlation of diffusion tensor imaging and phase-contrast MR with clinical parameters of cervical spinal cord injuries

Correlation of diffusion tensor imaging and phase-contrast MR with clinical parameters of cervical spinal cord injuries

Diffusion Tensor MR Imaging of the Neurologically Intact Human Spinal Cord

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

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