Keřkovský Miloš, Bednařík Josef, Jurová Barbora, Dušek Ladislav, Kadaňka Zdeněk, Kadaňka Zdeněk, Němec Martin, Kovaľová Ivana, Šprláková-Puková Andrea, Mechl Marek
Department of Radiology, University Hospital Brno, Czech Republic.
Faculty of Medicine, Masaryk University, Brno, Czech Republic.
J Neuroimaging. 2017 Jan;27(1):149-157. doi: 10.1111/jon.12372. Epub 2016 Jun 16.
Diffusion tensor imaging (DTI) has previously been used as a biomarker of myelopathy in patients with degenerative cervical cord compression (DCCC). However, many factors may affect the diffusion properties of the spinal cord. This prospective study seeks to identify sources of variability in spinal cord DTI parameters in both DCCC patients and healthy subjects.
The study group included 130 patients with DCCC confirmed by magnetic resonance imaging and 71 control subjects without signs of DCCC. DTI data of the cervical spine were acquired in all subjects. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were measured at different levels of the spinal cord (SCLs). Statistical data analysis was then used to determine diffusion parameters in terms of age, sex, SCL, and spinal cord compression.
Significant variations in FA and ADC values emerged when several spinal cord levels were mutually compared in the control group. FA values correlated significantly with age in the DCCC group and sex had a significant influence on ADC values in both groups. The two diffusion parameters in the DCCC group differed significantly between patients with clinical signs of mild-to-moderate myelopathy compared with asymptomatic patients, and correlated with measurements of spinal canal morphology.
Diffusion parameters of the cervical spinal cord were thus shown to respond significantly to spinal cord compression, but were subject to interaction with several other factors including sex, age, and SCL. These findings may be important to the interpretation of DTI measurements in individual patients.
扩散张量成像（DTI）此前已被用作退行性颈椎脊髓压迫症（DCCC）患者脊髓病的生物标志物。然而，许多因素可能会影响脊髓的扩散特性。这项前瞻性研究旨在确定DCCC患者和健康受试者脊髓DTI参数变异性的来源。
研究组包括130例经磁共振成像确诊的DCCC患者和71例无DCCC体征的对照受试者。所有受试者均获取了颈椎的DTI数据。在脊髓的不同水平（SCLs）测量分数各向异性（FA）和表观扩散系数（ADC）值。然后使用统计数据分析来确定年龄、性别、SCL和脊髓压迫方面的扩散参数。
在对照组中，当几个脊髓水平相互比较时，FA和ADC值出现了显著差异。在DCCC组中，FA值与年龄显著相关，在两组中性别对ADC值均有显著影响。与无症状患者相比，有轻至中度脊髓病临床体征的DCCC组患者的两个扩散参数存在显著差异，且与椎管形态测量值相关。
因此，颈椎脊髓的扩散参数对脊髓压迫有显著反应，但会受到包括性别、年龄和SCL在内的其他几个因素的相互作用影响。这些发现可能对个体患者DTI测量结果的解释很重要。
