Huang Shuting, Shao Haoyue, Liu Qiufeng, Liu Weiyin Vivian, Zhang Qiya, Deng Longyu, Liu Chaoxu, Omar Deeq Mohamed, Tang Xiangyu
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Dadao 1095#, Wuhan 430030, China.
MR Research, GE Healthcare, Beijing 100026, China.
Eur J Radiol. 2025 Sep;190:112214. doi: 10.1016/j.ejrad.2025.112214. Epub 2025 Jun 4.
To compare synthetic magnetic resonance imaging (MAGnetic resonance image Compilation, MAGiC) and MUSE-DTI (MUltiplexed Sensitivity Encoding-Diffusion Tensor Imaging) in determining the severity of spinal cord injury in cervical spondylotic myelopathy (CSM).
All subjects (69 CSM subjects and 15 controls) underwent synthetic MRI and MUSE-DTI scans. Japanese Orthopaedic Association (JOA) score was evaluated preoperatively. Cervical canal stenosis degree was graded 0-Ⅲ using an MRI grading system. Twelve patients received surgical intervention and JOA evaluation 1 year after operation. Regions of interest covered the whole spinal cord at the maximal compression level (MCL) and C2 vertebral level to generate T1, T2 and PD values from synthetic quantitative map and fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) values from MUSE-DTI map.
AD values demonstrated higher sensitivity to spinal microstructural changes than other parameters, increasing from Grade Ⅰ-Ⅲ and decreasing at Grade Ⅰ compared to Grade 0 (P < 0.05). FA and T1 values decreased from Grade 0-Ⅱ. Furthermore, AD values in Grade I were significantly lower than Grade 0 (P = 0.005). FA values correlated with the minimum FA values of multi-segment compressed spinal cord (P = 0.007). All MUSE-DTI parameters at MCL correlated with JOA scores across all grades. The preoperative AD values correlated with postoperative recovery rate, whereas MAGiC-derived parameters did not.
MUSE-DTI parameters better reflected microstructural alterations and secondary damages of spinal cord and correlated with the JOA scores and postoperative recovery rate. Therefore, MUSE-DTI could provide more quantitative information to evaluate the severity of spinal cord injury in CSM.
比较合成磁共振成像（磁共振图像合成，MAGiC）和MUSE-DTI（多重敏感性编码-扩散张量成像）在确定脊髓型颈椎病（CSM）脊髓损伤严重程度方面的效果。
所有受试者（69例CSM患者和15名对照者）均接受了合成MRI和MUSE-DTI扫描。术前评估日本骨科协会（JOA）评分。使用MRI分级系统将椎管狭窄程度分为0-Ⅲ级。12例患者在术后1年接受了手术干预和JOA评估。感兴趣区域覆盖最大压迫水平（MCL）和C2椎体水平的整个脊髓，以从合成定量图生成T1、T2和PD值，并从MUSE-DTI图生成分数各向异性（FA）、平均扩散率（MD）、轴向扩散率（AD）和径向扩散率（RD）值。
AD值对脊髓微观结构变化的敏感性高于其他参数，从Ⅰ级到Ⅲ级升高，与0级相比，Ⅰ级时降低（P<0.05）。FA和T1值从0级到Ⅱ级降低。此外，Ⅰ级的AD值显著低于0级（P=0.005）。FA值与多节段受压脊髓的最小FA值相关（P=0.007）。MCL处的所有MUSE-DTI参数与所有分级的JOA评分相关。术前AD值与术后恢复率相关，而MAGiC衍生参数则不然。
MUSE-DTI参数能更好地反映脊髓的微观结构改变和继发性损伤，并与JOA评分及术后恢复率相关。因此，MUSE-DTI可为评估CSM脊髓损伤的严重程度提供更多定量信息。
