扩散峰度成像在评估颈椎病患者脊髓微观结构变化中的作用。
Role of diffusion kurtosis imaging in evaluating microstructural changes in spinal cord of patients with cervical spondylosis.
机构信息
Department of Radiology, All India Institute of Medical Sciences, Rishikesh, 249203, India.
Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, India.
出版信息
Eur Spine J. 2023 Mar;32(3):986-993. doi: 10.1007/s00586-023-07559-x. Epub 2023 Feb 4.
STUDY DESIGN
Analytical cross-sectional study.
PURPOSE
To study the role of diffusion kurtosis imaging (DKI) in evaluating microstructural changes in patients with cervical spondylosis.
OVERVIEW OF LITERATURE
Cervical spondylosis is a common progressive degenerative disorder of the spine. Conventional magnetic resonance imaging (MRI) can only detect the changes in the spinal cord once there are visual signal changes; hence, it underestimates the extent of the injury. Newer imaging techniques like Diffusion Tensor and Kurtosis Imaging can evaluate the microstructural changes in cervical spinal cord before the obvious signal changes appear.
METHODS
Conventional MRI, diffusion tensor imaging (DTI), and DKI scans were performed for 90 cervical spondylosis patients on 1.5-T MR Siemens Magnetom aera after obtaining informed consent. Eight patients were excluded due to poor image quality. Fractional anisotropy (FA) colour maps and diffusion kurtosis (DK) maps corresponding to spinal cord cross sections at C2-C3 intervertebral disc level (control) and at the most stenotic levels were obtained. Modified Japanese Orthopaedic Association (mJOA) scoring was used for clinical assessment of the spinal cord function. The changes in DTI and DKI parameters and their correlation with mJOA scores were analysed by SPSS 23 software.
RESULTS
In our study, mean FA and mean kurtosis (MK) values at the stenotic level (0.54, 1.02) were significantly lower than values at the non-stenotic segment (0.70, 1.27). The mean diffusivity (MD) value at the stenotic segment (1.25) was significantly higher than in the non-stenotic segment (1.09). We also observed a strong positive correlation between mJOA score and FA and MK values and a negative correlation between mJOA score and MD values, suggesting a correlation of FA, MK, and MD with the clinical severity of the disease.
CONCLUSION
Addition of DTI and DKI sequences helps in early identification of the disease without any additional cost incurred by the patient.
研究设计
分析性横断面研究。
目的
研究扩散峰度成像（DKI）在评估颈椎病患者微观结构变化中的作用。
文献综述
颈椎病是一种常见的脊柱进行性退行性疾病。常规磁共振成像（MRI）仅在出现明显信号变化时才能检测到脊髓的变化；因此，它低估了损伤的程度。像扩散张量和峰度成像这样的新成像技术可以在明显的信号变化出现之前评估颈椎脊髓的微观结构变化。
方法
在获得知情同意后，对 90 名颈椎病患者在 1.5T MR 西门子 Magnetom aera 上进行常规 MRI、扩散张量成像（DTI）和 DKI 扫描。由于图像质量差，有 8 名患者被排除在外。获得 C2-C3 椎间盘水平（对照）和最狭窄水平脊髓横断面的分数各向异性（FA）彩色图和扩散峰度（DK）图。使用改良日本矫形协会（mJOA）评分对脊髓功能进行临床评估。使用 SPSS 23 软件分析 DTI 和 DKI 参数的变化及其与 mJOA 评分的相关性。
结果
在我们的研究中，狭窄水平的平均 FA 和平均峰度（MK）值（0.54，1.02）明显低于非狭窄节段（0.70，1.27）。狭窄节段的平均弥散度（MD）值（1.25）明显高于非狭窄节段（1.09）。我们还观察到 mJOA 评分与 FA 和 MK 值呈强正相关，与 MD 值呈负相关，表明 FA、MK 和 MD 与疾病的临床严重程度相关。
结论
添加 DTI 和 DKI 序列有助于在不增加患者额外费用的情况下早期识别疾病。
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