Gao Yuan, Sun Chi, Zhou Shuyi, Zhang Fan, Jiang Jianyuan, Zhang Jun, Wang Hongli
Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China.
Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.
Global Spine J. 2024 Nov;14(8):2347-2357. doi: 10.1177/21925682231181871. Epub 2023 Jun 7.
This study aimed to explore the relationship between diffusion tensor imaging (DTI) parameters, cervical spine alignments, and spinal cord morphological parameters in patients with Hirayama disease (HD).
In this retrospective cohort study, 41 HD patients were recruited from the Huashan hospital from July 2017 to November 2021. Patients received X-rays, conventional magnetic resonance (MR), and DTI scans in flexion and neutral positions. The DTI parameters assessed were calculated using the region of interest (ROI) method. Paired t-tests were performed on the DTI parameters of neck flexion and neutral position. Cervical spine alignments, including flexion and neutral Cobb angles, were measured, and range of motion (ROM) was calculated. Spinal cord morphological parameters were measured, including spinal cord atrophy (SCA) and loss of attachment (LOA). Spearman's correlation analysis between DTI parameters, cervical spine alignments, and spinal cord morphological parameters was performed.
In comparing DTI parameters, segments of the C3/4, C4/5, C6/7, and lower cervical spine were significantly different, while segments of C5/6 were not significantly different. In Spearman's correlation analysis, the flexion Cobb angle was significantly correlated with the fractional anisotropy (FA) value ( = .111, P = .033) and apparent diffusion coefficient (ADC) value ( = .119, = .027). Flexion FA values were correlated with SCA in C4/5 ( = .211, P = .003), C5/6 ( = .454, P < .001), and C6/7 ( = .383, < .001) while flexion ADC values were correlated with SCA in the C4/5 ( = .178, = .006), C5/6 ( = .388, P < .001) and C6/7 segments ( = .187, P = .005).
The DTI parameters were correlated with the flexion Cobb angle and the SCA. These data support the dynamic cervical flexion compression hypothesis and indicate that the degree of SCA may be used to assess the condition of HD patients quantitatively.
本研究旨在探讨平山病（HD）患者的扩散张量成像（DTI）参数、颈椎排列和脊髓形态学参数之间的关系。
在这项回顾性队列研究中，2017年7月至2021年11月期间从华山医院招募了41例HD患者。患者在颈椎前屈位和中立位接受了X线、常规磁共振（MR）和DTI扫描。使用感兴趣区（ROI）方法计算评估的DTI参数。对颈椎前屈位和中立位的DTI参数进行配对t检验。测量颈椎排列，包括前屈和中立位的Cobb角，并计算活动范围（ROM）。测量脊髓形态学参数，包括脊髓萎缩（SCA）和附着丧失（LOA）。对DTI参数、颈椎排列和脊髓形态学参数进行Spearman相关性分析。
比较DTI参数时，C3/4、C4/5、C6/7节段及下颈椎节段有显著差异，而C5/6节段无显著差异。在Spearman相关性分析中，前屈Cobb角与各向异性分数（FA）值（r = 0.111，P = 0.033）和表观扩散系数（ADC）值（r = 0.119，P = 0.027）显著相关。前屈FA值与C4/5（r = 0.211，P = 0.003）、C5/6（r = 0.454，P < 0.001）和C6/7（r = 0.383，P < 0.001）节段的SCA相关，而前屈ADC值与C4/5（r = 0.178，P = 0.006）、C5/6（r = 0.388，P < 0.001）和C6/7节段（r = 0.187，P = 0.005）的SCA相关。
DTI参数与前屈Cobb角和SCA相关。这些数据支持动态颈椎前屈压迫假说，并表明SCA的程度可用于定量评估HD患者的病情。
