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Cervical Spine Prospective Feasibility Study

Dynamic Flexion-Extension Diffusion-Tensor Weighted Magnetic Resonance Imaging

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Abstract

Purpose

Diffusion tensor imaging (DTI) in flexion-extension may serve as a diagnostic tool to improve the sensitivity for detection of myelopathy. In this study, the feasibility and reproducibility of dynamic DTI in the cervical spinal cord was assessed in healthy volunteers and patients.

Methods

All subjects were examined in maximum neck flexion-extension in a 3T magnetic resonance imaging (MRI) scanner. Range of motion, space available for the spinal cord, fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured and compared between the neck positions.

Results

Volunteers showed no variation in ADC and FA. In patients, extension produced higher ADC in the diseased than in the control segments (p = 0.0045). The ADC of the affected segments was higher in extension than in the neutral position (p = 0.0030) or in flexion (p = 0.0002). The FA was significantly lower in extension in patients at both the control level C2/3 (p = 0.0154) and the affected segment (p = 0.0187).

Conclusions

Dynamic DTI of the cervical spine is feasible and ADC increased in the patient group in extension. This finding may open a previously unexplored avenue to attempt an earlier identification of myelopathy.

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Author information

Authors and Affiliations

  1. Department of Neuroradiology, Cantonal Hospital Aarau, Tellstraße 25, 5001, Aarau, Switzerland

    Bawarjan Schatlo, Luca Remonda & Jatta Berberat

  2. Department of Neurosurgery, Cantonal Hospital Aarau, Aarau, Switzerland

    Bawarjan Schatlo & Javier Fandino

  3. Department of Neurosurgery, University Medicine Göttingen, Georg-August University, Göttingen, Germany

    Bawarjan Schatlo & Veit Rohde

  4. Department of Neurology, Cantonal Hospital Aarau, Aarau, Switzerland

    Philipp Gruber

  5. Department of Neurosurgery, Hirslanden Clinik, Aarau, Switzerland

    Ali-Reza Fathi

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  1. Bawarjan Schatlo
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Correspondence to Jatta Berberat.

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Conflict of interest

B. Schatlo, L. Remonda, P. Gruber, J. Fandino, V. Rohde, A.-R Fathi and J Berberat declare that they have no competing interests.

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Schatlo, B., Remonda, L., Gruber, P. et al. Cervical Spine Prospective Feasibility Study. Clin Neuroradiol 29, 523–532 (2019). https://doi.org/10.1007/s00062-018-0686-0

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  • DOI: https://doi.org/10.1007/s00062-018-0686-0

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