Department of CTMRI, The Third Hospital of HeBei Medical University, ShijiaZhuang, 050051, China.
Department of Radiology and Nuclear Medicine, The First Hospital of HeBei Medical University, No. 89 Donggang Road, ShijiaZhuang, 050000, China.
Eur Spine J. 2024 Oct;33(10):3949-3956. doi: 10.1007/s00586-024-08411-6. Epub 2024 Sep 4.
To investigate the clinical application of zonally magnified oblique multislice (ZOOM) imaging technology in patients with degenerative cervical myelopathy (DCM) and compare it with T2WI imaging.
A total of 111 patients diagnosed with DCM were recruited. According to mJOA, patients with DCM were divided into ND + group with neurological dysfunction and ND- group without neurological dysfunction. Routine MRI and ZOOM-DWI were performed on 3.0 T MRI to obtain sagittal T2WI and apparent diffusion coefficient (ADC) diagram. ADC values of the narrow segment and its adjacent upper and lower segments were measured, and compared between the ND + and ND- groups. The correlation between ADC value of cervical spinal cord and mJOA score was analyzed. Additionally, ROC curves were plotted to calculate the AUC values.
The comparison between ND + and ND- groups shows that there are significant differences in mJOA score, T2WI, anteroposterior diameter of spinal canal, ADC values of narrow, upper and lower segment (P < 0.05). In ND + group, there is a significant difference between ADC values of the narrow and its upper and lower segments (P < 0.001), while with no significant difference in ADC values of the upper and lower segments (P > 0.05). Results of correlation analysis indicate that in the ND + group, neurological dysfunction evaluated by mJOA scores is correlated with increased ADC values of the narrow segment (r = -0.52, P < 0.001), but not significantly correlated with ADC values of the upper and lower segments. Furthermore, T2WI, anteroposterior diameter of the spinal canal, and cervical cord ADC values all has diagnostic efficacy in evaluating neurological dysfunction in DCM (AUC > 0.5, P < 0.05), with the ADC value of the narrow segment being optimal.
The ADC value of spinal cord obtained by small-field ZOOM-DWI can be used to evaluate neurological dysfunction in DCM, and is superior to traditional T2WI.
探讨区域放大斜位多层面（ZOOM）成像技术在退行性颈椎病（DCM）患者中的临床应用，并与 T2WI 成像进行比较。
共纳入 111 例经诊断为 DCM 的患者。根据 mJOA，将 DCM 患者分为有神经功能障碍的 ND+组和无神经功能障碍的 ND-组。在 3.0T MRI 上进行常规 MRI 和 ZOOM-DWI，获取矢状位 T2WI 和表观扩散系数（ADC）图。测量狭窄段及其相邻上下段的 ADC 值，并比较 ND+组和 ND-组之间的差异。分析颈髓 ADC 值与 mJOA 评分的相关性。此外，绘制 ROC 曲线以计算 AUC 值。
ND+组和 ND-组比较显示，mJOA 评分、T2WI、椎管前后径、狭窄段及上下段 ADC 值均有显著差异（P<0.05）。在 ND+组中，狭窄段及其上下段的 ADC 值有显著差异（P<0.001），而上下段 ADC 值无显著差异（P>0.05）。相关性分析结果表明，在 ND+组中，mJOA 评分评估的神经功能障碍与狭窄段 ADC 值升高相关（r=-0.52，P<0.001），但与上下段 ADC 值无显著相关性。此外，T2WI、椎管前后径和颈髓 ADC 值在评估 DCM 神经功能障碍方面均具有诊断效能（AUC>0.5，P<0.05），其中狭窄段 ADC 值最佳。
小视野 ZOOM-DWI 获得的脊髓 ADC 值可用于评估 DCM 患者的神经功能障碍，且优于传统 T2WI。
