Ying Jinwei, Zhou Xiaojun, Zhu Minyu, Zhou Yang, Huang Kelun, Zhou Beibei, Teng Honglin
Department of Spine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Eur Neurol. 2016;75(1-2):67-74. doi: 10.1159/000443270. Epub 2016 Feb 2.
BACKGROUND/AIMS: This study aimed at assessing the feasibility of diffusion tensor imaging (DTI) in multilevel cervical spondylotic myelopathy (MCSM) and quantifying the association between DTI parameters and neuronal status as a whole.
Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were obtained from 32 patients with MCSM and 21 healthy volunteers at each level. The extent of cervical cord compression was evaluated by maximum spinal cord compression (MSCC). The DTI parameters were correlated with myelopathy severity based on modified Japanese Orthopedic Association (mJOA) score in comparison with anatomic morphological and signal changes on MRI.
There were significant differences in the DTI values between the patients and those in the control group (p < 0.001). The general mean FA values correlated with mJOA scores strongly (r = 0.507, p = 0.003), even more than MSCC (r = -0.361, p = 0.042); however, such an association was not detected between ADC values and clinical findings (p > 0.05).
DTI shows a higher potential to quantitatively evaluate the whole neurological deficits of patients with MCSM. It helps us better understand the minor pathological changes within the spinal cord at an earlier stage than abnormal signal changes on MRI.
背景/目的：本研究旨在评估弥散张量成像（DTI）在多节段脊髓型颈椎病（MCSM）中的可行性，并整体量化DTI参数与神经元状态之间的关联。
从32例MCSM患者和21名健康志愿者的每个节段获取分数各向异性（FA）和表观扩散系数（ADC）。通过最大脊髓压迫（MSCC）评估脊髓压迫程度。将DTI参数与基于改良日本骨科学会（mJOA）评分的脊髓病严重程度相关联，并与MRI上的解剖形态和信号变化进行比较。
患者与对照组之间的DTI值存在显著差异（p < 0.001）。总体平均FA值与mJOA评分密切相关（r = 0.507，p = 0.003），甚至超过MSCC（r = -0.361，p = 0.042）；然而，未发现ADC值与临床结果之间存在这种关联（p > 0.05）。
DTI在定量评估MCSM患者的整体神经功能缺损方面具有更高的潜力。与MRI上的异常信号变化相比，它有助于我们在更早阶段更好地了解脊髓内的微小病理变化。
