Department of Radiology, Peking University Third Hospital, Beijing, China.
Institute of Statistics and Big Data, Renmin University of China, Beijing, China.
J Magn Reson Imaging. 2024 Feb;59(2):599-610. doi: 10.1002/jmri.28789. Epub 2023 May 18.
Diffusion magnetic resonsance imaging (dMRI) can potentially predict the postoperative outcome of cervical spondylotic myelopathy (CSM).
To explore preoperative dMRI parameters to predict the postoperative outcome of CSM through multifactor correlation analysis.
Prospective.
Post-surgery CSM patients; 102 total, 73 male (52.42 ± 10.60 years old) and 29 female (52.0 ± 11.45 years old).
FIELD STRENGTH/SEQUENCE: 3.0 T/Turbo spin echo T1/T2-weighted, T2*-weighted multiecho gradient echo and dMRI.
Spinal cord function was evaluated using modified Japanese Orthopedic Association (mJOA) scoring at different time points: preoperative and 3, 6, and 12 months postoperative. Single-factor correlation and t test analyses were conducted based on fractional anisotropy (FA), mean diffusivity, intracellular volume fraction, isotropic volume fraction, orientation division index, increased signal intensity, compression ratio, age, sex, symptom duration and operation method, and multicollinearity was calculated. The linear quantile mixed model (LQMM) and the linear mixed-effects regression model (LMER) were used for multifactor correlation analysis using the combinations of the above variables.
Distance correlation, Pearson's correlation, multiscale graph correlation and t tests were used for the single-factor correlation analyses. The variance inflation factor (VIF) was used to calculate multicollinearity. LQMM and LMER were used for multifactor correlation analyses. P < 0.05 was considered statistically significant.
The single-factor correlation between all variables and the postoperative mJOA score was weak (all r < 0.3). The linear relationship was stronger than the nonlinear relationship, and there was no significant multicollinearity (VIF = 1.10-1.94). FA values in the LQMM and LMER models had a significant positive correlation with the mJOA score (r = 5.27-6.04), which was stronger than the other variables.
The FA value based on dMRI significantly positively correlated with CSM patient postoperative outcomes, helping to predict the surgical outcome and formulate a treatment plan before surgery.
1 TECHNICAL EFFICACY: Stage 2.
弥散磁共振成像（dMRI）有可能预测颈椎脊髓病（CSM）的术后结果。
通过多因素相关分析，探讨术前 dMRI 参数对 CSM 术后结果的预测作用。
前瞻性。
术后 CSM 患者；共 102 例，其中男性 73 例（52.42±10.60 岁），女性 29 例（52.0±11.45 岁）。
磁场强度/序列：3.0T/Turbo 自旋回波 T1/T2 加权、T2*-加权多回波梯度回波和 dMRI。
采用改良日本矫形协会（mJOA）评分在不同时间点评估脊髓功能：术前和术后 3、6、12 个月。对各向异性分数（FA）、平均弥散度、细胞内容积分数、各向同性容积分数、定向分数指数、信号强度增高、压缩比、年龄、性别、症状持续时间、手术方法等进行单因素相关性分析和 t 检验，并计算多重共线性。采用线性分位数混合模型（LQMM）和线性混合效应回归模型（LMER），使用上述变量的组合进行多因素相关性分析。
单因素相关性分析采用距离相关、Pearson 相关、多尺度图相关和 t 检验。方差膨胀因子（VIF）用于计算多重共线性。采用 LQMM 和 LMER 进行多因素相关性分析。P＜0.05 为统计学显著差异。
所有变量与术后 mJOA 评分的单因素相关性均较弱（均 r＜0.3）。线性关系强于非线性关系，且无显著多重共线性（VIF=1.10-1.94）。LQMM 和 LMER 模型中 FA 值与 mJOA 评分呈显著正相关（r=5.27-6.04），相关性强于其他变量。
基于 dMRI 的 FA 值与 CSM 患者术后结果显著正相关，有助于预测手术效果，并在术前制定治疗方案。
1 级 技术效能：2 级。
