Wang X, Tian X, Peng Y, Zhang D, Wang Y, Zhang L
Department of Radiology and Nuclear Medicine, The First Hospital of Hebei Medical University, Shijiazhuang, China.
CT Room, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
Clin Radiol. 2025 Aug;87:106974. doi: 10.1016/j.crad.2025.106974. Epub 2025 May 27.
To investigate the applied value of quantitative assessment of the cervical spondylotic myelopathy (CSM) severity using T1 mapping of cervical spinal cord.
A total of 133 patients with CSM (CSM group) and 30 healthy volunteers (control group) were prospectively recruited between September 2023 and March 2024. Patients with CSM were categorized into a mild group (mJOA ≥12) and a severe group (mJOA <12) according to the modified Japanese Orthopedic Association scores (mJOA). Cervical axial and sagittal T2WI, as well as sagittal T1 mapping were performed on all subjects. In the control group, native T1 was measured at each disc level (C2-C7); in the CSM group, native T1 was measured at the stenotic location, the disc level above and below the stenotic location (T1,T1 and T1). Interobserver agreement, univariate analyses, pearson's correlations, and ROC curves were performed.
Native T1 showed excellent interobserver agreement in the control group. The mean T1 value of the control group (772.94 ± 57.87 ms) was significantly lower than the T1(908.89 ± 135.61ms),T1 (844.66 ± 126.97ms) and T1 (855.99 ± 125.52ms).The distribution of mJOA, T2(+), T1 , T1 and T1 between the mild and severe groups differed (P<0.05). All native T1 of CSM group showed negative correlations with mJOA. AUCs of T1 ,T1 and T1 identified the severity of CSM patients as 0.857, 0.711, and 0.733, respectively.
T1 mapping can quantitatively assess the severity of CSM patients, and native T1 of spinal cord at the stenosis level is a valuable parameter to differentiate between patients with mild and severe CSM.
探讨采用颈髓T1映射定量评估脊髓型颈椎病（CSM）严重程度的应用价值。
2023年9月至2024年3月前瞻性招募了133例CSM患者（CSM组）和30名健康志愿者（对照组）。根据改良日本骨科学会评分（mJOA）将CSM患者分为轻度组（mJOA≥12）和重度组（mJOA<12）。对所有受试者进行颈椎轴位和矢状位T2WI以及矢状位T1映射检查。在对照组中，在每个椎间盘水平（C2-C7）测量固有T1；在CSM组中，在狭窄部位、狭窄部位上方和下方的椎间盘水平测量固有T1（T1、T1和T1）。进行了观察者间一致性分析、单因素分析、Pearson相关性分析和ROC曲线分析。
对照组中固有T1显示出良好的观察者间一致性。对照组的平均T1值（772.94±57.87毫秒）显著低于T1（908.89±135.61毫秒）、T1（844.66±126.97毫秒）和T1（855.99±125.52毫秒）。轻度组和重度组之间mJOA、T2（+）、T1、T1和T1的分布存在差异（P<0.05）。CSM组的所有固有T1与mJOA均呈负相关。T1、T1和T1的AUC分别将CSM患者的严重程度判定为0.857、0.711和0.733。
T1映射可定量评估CSM患者的严重程度，狭窄水平脊髓的固有T1是区分轻度和重度CSM患者的有价值参数。
