Department of Radiology, University Hospital, Brno and Masaryk University, Brno, Czech Republic.
Spine (Phila Pa 1976). 2012 Jan 1;37(1):48-56. doi: 10.1097/BRS.0b013e31820e6c35.
STUDY DESIGN: A prospective study evaluating a cohort of patients with spondylotic cervical spine compression. OBJECTIVE: To analyze the potential of diffusion tensor imaging (DTI) of the cervical spinal cord in the detection of changes associated with spondylotic myelopathy, with particular reference to clinical and electrophysiological findings. SUMMARY OF BACKGROUND DATA: Conventional magnetic resonance imaging (MRI) may provide confusing findings because of a frequent disproportion between the degree of the spinal cord compression and clinical symptoms. The DTI is known to be more sensitive to subtle pathological changes of the spinal cord compared with conventional MRI. METHODS: The DTI of the cervical spinal cord was performed within a group of 52 patients with spondylotic spinal cord compression and 13 healthy volunteers on a 1.5-T MRI scanner. All patients underwent clinical examination that differentiated between asymptomatic and symptomatic myelopathy subgroups, and 45 patients underwent electrophysiological examination. We measured the apparent diffusion coefficient and fractional anisotropy of the spinal cord at C2/C3 level without compression and at the maximal compression level (MCL). Sagittal spinal canal diameter, cross-sectional spinal cord area, and presence of T2 hyperintensity at the MCL were also recorded. Nonparametric statistical testing was used for comparison of controls with subgroups of patients. RESULTS: Significant differences in both the DTI parameters measured at the MCL, between patients with compression and control group, were found, while no difference was observed at the noncompression level. Moreover, fractional anisotropy values were lower and apparent diffusion coefficient values were higher at the MCL in the symptomatic patients than in the asymptomatic patients. The DTI showed higher potential to discriminate between clinical subgroups in comparison with standard MRI parameters and electrophysiological findings. CONCLUSION: The DTI appears to be a promising imaging modality in patients with spondylotic spinal cord compression. It reflects the presence of symptomatic myelopathy and shows considerable potential for discriminating between symptomatic and asymptomatic patients.
研究设计：一项前瞻性研究，评估了一组患有颈椎脊髓压迫症的患者。
目的：分析颈椎脊髓弥散张量成像（DTI）在检测与颈椎病相关变化方面的潜力，特别关注临床和电生理发现。
背景资料概要：常规磁共振成像（MRI）可能会提供混淆的结果，因为脊髓受压的程度与临床症状之间经常存在不成比例的情况。与常规 MRI 相比，DTI 被认为对脊髓的细微病理变化更敏感。
方法：在一组 52 例颈椎病脊髓压迫患者和 13 名健康志愿者中，在 1.5T MRI 扫描仪上进行颈椎脊髓 DTI。所有患者均接受了临床检查，以区分无症状和有症状的脊髓病亚组，45 例患者接受了电生理检查。我们在没有压迫的 C2/C3 水平和最大压迫水平（MCL）测量脊髓的表观扩散系数和各向异性分数。还记录了矢状椎管直径、脊髓横截面积以及 MCL 处 T2 高信号的存在。使用非参数统计检验比较对照组和患者亚组。
结果：在 MCL 处，与对照组相比，受压患者的 DTI 参数均有显著差异，而在非受压水平则无差异。此外，在有症状的患者中，MCL 处的各向异性分数较低，表观扩散系数值较高。与标准 MRI 参数和电生理发现相比，DTI 在区分临床亚组方面显示出更高的潜力。
结论：DTI 似乎是颈椎病患者有前途的成像方式。它反映了有症状的脊髓病的存在，并显示出相当大的潜力来区分有症状和无症状的患者。
Spine (Phila Pa 1976). 2014-5-1
Acta Chir Orthop Traumatol Cech. 2015
Spine (Phila Pa 1976). 2014-7-1
J Clin Med. 2024-11-25
J Clin Med. 2023-5-8
Acta Neurochir (Wien). 2023-5
Zotero 插件