From the Department of Neurology (N.M.-O., M.T., X.M., J.S.-G.), Multiple Sclerosis Centre of Catalonia.
Section of Neuroradiology (D.P., M.A., À.R.), Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
AJNR Am J Neuroradiol. 2023 Jul;44(7):867-872. doi: 10.3174/ajnr.A7899. Epub 2023 Jun 8.
As in the brain reserve concept, a larger cervical canal area may also protect against disability. In this context, a semiautomated pipeline has been developed to obtain quantitative estimations of the cervical canal area. The aim of the study was to validate the pipeline, to evaluate the consistency of the cervical canal area measurements during a 1-year period, and to compare cervical canal area estimations obtained from brain and cervical MRI acquisitions.
Eight healthy controls and 18 patients with MS underwent baseline and follow-up 3T brain and cervical spine sagittal 3D MPRAGE. The cervical canal area was measured in all acquisitions, and estimations obtained with the proposed pipeline were compared with manual segmentations performed by 1 evaluator using the Dice similarity coefficient. The cervical canal area estimations obtained on baseline and follow-up T1WI were compared; brain and cervical cord acquisitions were also compared using the individual and average intraclass correlation coefficients.
The agreement between the manual cervical canal area masks and the masks provided by the proposed pipeline was excellent, with a mean Dice similarity coefficient mean of 0.90 (range, 0.73-0.97). The cervical canal area estimations obtained from baseline and follow-up scans showed a good level of concordance (intraclass correlation coefficient = 0.76; 95% CI, 0.44-0.88); estimations obtained from brain and cervical MRIs also had good agreement (intraclass correlation coefficient = 0.77; 95% CI, 0.45-0.90).
The proposed pipeline is a reliable tool to estimate the cervical canal area. The cervical canal area is a stable measure across time; moreover, when cervical sequences are not available, the cervical canal area could be estimated using brain T1WI.
正如大脑储备概念一样，较大的椎管面积也可能对残疾起到保护作用。在这种情况下，已经开发出一种半自动管道，以获得椎管面积的定量估计。本研究的目的是验证该管道，评估在 1 年期间椎管面积测量的一致性，并比较来自脑部和颈部 MRI 采集的椎管面积估计。
8 名健康对照者和 18 名 MS 患者进行了基线和随访的 3T 脑部和颈椎矢状 3D MPRAGE。在所有采集的图像上测量了椎管面积，并使用 Dice 相似系数比较了由 1 名评估者使用提出的管道获得的估计值与手动分割的结果。比较了基线和随访 T1WI 上的椎管面积估计值；还使用个体和平均组内相关系数比较了脑部和颈髓采集。
手动椎管面积掩模与提出的管道提供的掩模之间的一致性很好，平均 Dice 相似系数为 0.90（范围，0.73-0.97）。从基线和随访扫描中获得的椎管面积估计值具有良好的一致性（组内相关系数=0.76；95%置信区间，0.44-0.88）；从脑部和颈部 MRI 获得的估计值也具有很好的一致性（组内相关系数=0.77；95%置信区间，0.45-0.90）。
提出的管道是一种可靠的工具，可以估计椎管面积。椎管面积是一个随时间稳定的测量值；此外，当没有颈部序列时，可以使用脑部 T1WI 估计椎管面积。
