Ulubaba Hilal Er, Saglik Semih, Yildirim Ismail Okan, Durak Mehmet Akif
Malatya Yesilyurt Hasan Calik State Hospital, Department of Radiology, Malatya, Turkey.
Turk Neurosurg. 2021;31(1):67-72. doi: 10.5137/1019-5149.JTN.29149-20.2.
AIM: To determine the effectiveness of diffusion tensor imaging (DTI) in diagnosing cervical spondylotic myelopathy (CSM) in patients with no findings detected in conventional magnetic resonance imaging (MRI). MATERIAL AND METHODS: Fifty-four patients who presented for cervical MRI between January 2016 and June 2016, with symptoms such as neck pain, paresis, and numbness in hands, were included in the study. The patients were split into four groups based on their degrees of spinal stenosis. The obtained data were examined using special software and color-coded fractional anisotropy (FA), and apparent diffusion coefficient (ADC) maps were formed. Through these maps, using regions of interest (ROIs), FA and ADC values were calculated and the contribution of these values to the diagnosis was evaluated statistically. RESULTS: When all grades of cervical spinal canal stenosis were compared, a statistically significant negative correlation between spinal canal stenosis degree and FA values, and a positive correlation between stenosis degree and ADC values were noted (p < 0.001). In the comparison of stenotic levels and non-stenotic levels for the grade 2 patient group, there was a statistically significant decrease in FA values and an increase in ADC values in stenotic levels compared with prestenotic and poststenotic levels (p < 0.05). CONCLUSION: DTI and quantitative FA and ADC measurements are candidate imaging techniques for the diagnosis of early-stage CSM, which shows no findings in conventional MRI, and determining the degree of spinal cord injury.
目的:确定弥散张量成像(DTI)在诊断常规磁共振成像(MRI)未发现异常的脊髓型颈椎病(CSM)患者中的有效性。 材料与方法:纳入2016年1月至2016年6月期间因颈部MRI检查就诊,有颈部疼痛、肢体无力和手部麻木等症状的54例患者。根据椎管狭窄程度将患者分为四组。使用专用软件对获得的数据进行检查,并生成彩色编码的分数各向异性(FA)图和表观扩散系数(ADC)图。通过这些图,利用感兴趣区(ROI)计算FA和ADC值,并对这些值在诊断中的作用进行统计学评估。 结果:比较所有级别的颈椎管狭窄时,发现椎管狭窄程度与FA值之间存在统计学显著的负相关,狭窄程度与ADC值之间存在正相关(p < 0.001)。在2级患者组的狭窄节段与非狭窄节段比较中,与狭窄前和狭窄后节段相比,狭窄节段的FA值有统计学显著降低,ADC值升高(p < 0.05)。 结论:DTI以及定量FA和ADC测量是诊断早期CSM(在常规MRI中无异常表现)和确定脊髓损伤程度的候选成像技术。
J Neurol Surg A Cent Eur Neurosurg. 2020-1