Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230036, China.
Comput Math Methods Med. 2022 Mar 19;2022:4957275. doi: 10.1155/2022/4957275. eCollection 2022.
To explore the characteristics of magnetic resonance diffusion tensor imaging (DTI) parameters in patients with high cervical spinal myeloma and the evaluation of postoperative spinal cord function.
In recent years, 42 patients with high cervical spine myeloma were selected as the observation group, and 42 healthy volunteers were selected as the control group during the same period. The apparent dispersion coefficient (ADC), the fractional anisotropy (FA), the number of fiber bundles (FT), and the fiber bundle ratio (FTR) were compared between the two groups. The correlation between the ADC, FA, FT, FTR, and the International Standard for Neurological Classification of Spinal Cord Injury (ISNCSCI) score in the observation group were analyzed. Spinal cord function was evaluated using the Japanese Orthopaedic Association Score (JOA). Logistic regression model was used to analyze the factors affecting the recovery of spinal cord function after surgery. The receiver operating characteristic curve (ROC) was used to analyze the value of ADC, FA, FT, FTR1, and FTR2 in predicting the recovery of spinal cord function.
The ADCs of the lesion layer and lower layer of the observation group were higher than the middle and lower layers of the control group, the FA and FT were lower than the middle and lower layers of the control group, and FTR1 and FTR2 were lower than those of the control group ( < 0.05). The ADC of the lesion layer in the observation group was negatively correlated with ISNCSCI score, and the FA, FT, FTR1, FTR2, and ISNCSCI scores were positively correlated ( < 0.05). Three months after the operation, JOA was used to evaluate the spinal cord function, which was excellent in 23 cases and poor in 19 cases. Logistic regression model analysis showed that after the ISNCSCI score was controlled, the increase in ADC and the decrease in FA, FT, FTR1, and FTR2 of the lesion layer were independent risk factors for poor postoperative body function recovery ( < 0.05). ROC analysis showed that the combination of ADC, FA, FT, FTR1, and FTR2 of the lesion layer predicted the AUC of spinal cord functional recovery was 0.941, which was better than the single prediction ( < 0.05).
The abnormal DTI parameter values of patients with high cervical spinal myeloma can better reflect the lack of spinal cord function, and they can effectively predict the recovery of the patient's body function after surgery, providing a reference for clinical diagnosis and treatment.
探讨高位颈髓肿瘤患者磁共振扩散张量成像（DTI）参数特征及对术后脊髓功能的评估。
选取近年来收治的高位颈髓肿瘤患者 42 例作为观察组，同期选取健康志愿者 42 例作为对照组，比较两组的表观弥散系数（ADC）、各向异性分数（FA）、纤维束数量（FT）、纤维束比值（FTR），分析观察组 ADC、FA、FT、FTR 与国际脊髓损伤神经分类标准（ISNCSCI）评分的相关性。采用日本矫形协会评分（JOA）评估脊髓功能，采用 logistic 回归模型分析影响术后脊髓功能恢复的因素，采用受试者工作特征曲线（ROC）分析 ADC、FA、FT、FTR1、FTR2 预测脊髓功能恢复的价值。
观察组病变层及下层面 ADC 值高于对照组中、下层面，FA、FT 值低于对照组中、下层面，FTR1、FTR2 值低于对照组（ < 0.05）。观察组病变层 ADC 与 ISNCSCI 评分呈负相关，FA、FT、FTR1、FTR2 与 ISNCSCI 评分呈正相关（ < 0.05）。术后 3 个月采用 JOA 评估脊髓功能，其中优 23 例，差 19 例。logistic 回归模型分析显示，在控制 ISNCSCI 评分后，病变层 ADC 增加及 FA、FT、FTR1、FTR2 降低是术后躯体功能恢复不良的独立危险因素（ < 0.05）。ROC 分析显示，病变层 ADC、FA、FT、FTR1、FTR2 联合预测脊髓功能恢复的 AUC 为 0.941，优于单项预测（ < 0.05）。
高位颈髓肿瘤患者的 DTI 参数异常值能更好地反映脊髓功能缺失，能有效预测患者术后躯体功能的恢复情况，为临床诊断及治疗提供参考。
