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Diffusion tensor imaging with fiber tracking provides a valuable quantitative and clinical evaluation for compressed lumbosacral nerve roots: a systematic review and meta-analysis

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Abstract

Purpose

This study aimed to investigate the diagnostic value of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of the diffusion tensor imaging (DTI) with fiber tracking in patients with compressed lumbosacral nerve roots.

Methods

A systematic literature search of databases (PubMed, Embase, Cochrane Library, and Web of Science) was carried out. FA values and ADC values were compared between compressed nerve roots and healthy controls. Pooled and subgroup analyses were performed using fixed or random-effect models based on I2 heterogeneity.

Results

A total of 262 patients from ten studies with 285 compressed lumbosacral nerve roots and 285 contralateral normal nerve roots were included in the meta-analysis. It was showed in pooled results that FA value was significantly reduced (SMD  − 3.03, 95% CI [ − 3.75 to  − 2.31], P < 0.001) and ADC value was significantly increased (SMD 2.07, 95% CI [0.92 to 3.22], P < 0.001) in the compressed nerve roots, compared with contralateral normal nerve roots. Subgroup analysis comparing the FA values and ADC values in different nerve root ranges (L2–S1, L4–S1, L5–S1, L5, S1) revealed the different ranges of nerve roots were possible sources of heterogeneity.

Conclusions

This study showed that FA value reduction and ADC value increase were valuable indicators of compressed lumbosacral nerve roots. These changes may be related to the neurological symptoms of patients. DTI with fiber tracking can directly visualize and accurately locate the compression zone of nerve roots to help make surgical treatment plans, is more advanced than conventional MRI.

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Funding

This work was supported by the National Natural Science Foundation of China (No. 8167090209).

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Authors and Affiliations

  1. Department of Orthopedics, Beijing Chao-Yang Hospital, Capital Medical University, GongTiNanLu 8#, Chao-Yang District, Beijing, 100020, China

    Weishi Liang, Bo Han, Yong Hai, Peng Yin, Yuxiang Chen & Congying Zou

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  1. Weishi Liang
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  2. Bo Han
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  3. Yong Hai
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  4. Peng Yin
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  5. Yuxiang Chen
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  6. Congying Zou
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Contributions

All authors contributed to the review conception and design. Material preparation, data collection and analysis were performed by YH, WSL, and BH. The first draft of the manuscript was written by WSL and the work was critically revised by BH and YH. All authors commented on previous versions of the manuscript, as well as, read and approved the final manuscript.

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Correspondence to Yong Hai.

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All authors declare that there are no conflicts of interest.

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Weishi Liang and Bo Han contribute equally to this work, and they are the co-first authors.

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Liang, W., Han, B., Hai, Y. et al. Diffusion tensor imaging with fiber tracking provides a valuable quantitative and clinical evaluation for compressed lumbosacral nerve roots: a systematic review and meta-analysis. Eur Spine J 30, 818–828 (2021). https://doi.org/10.1007/s00586-020-06556-8

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