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Role of diffusion kurtosis imaging in evaluating microstructural changes in spinal cord of patients with cervical spondylosis

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Abstract

Study design

Analytical cross-sectional study.

Purpose

To study the role of diffusion kurtosis imaging (DKI) in evaluating microstructural changes in patients with cervical spondylosis.

Overview of literature

Cervical spondylosis is a common progressive degenerative disorder of the spine. Conventional magnetic resonance imaging (MRI) can only detect the changes in the spinal cord once there are visual signal changes; hence, it underestimates the extent of the injury. Newer imaging techniques like Diffusion Tensor and Kurtosis Imaging can evaluate the microstructural changes in cervical spinal cord before the obvious signal changes appear.

Methods

Conventional MRI, diffusion tensor imaging (DTI), and DKI scans were performed for 90 cervical spondylosis patients on 1.5-T MR Siemens Magnetom aera after obtaining informed consent. Eight patients were excluded due to poor image quality. Fractional anisotropy (FA) colour maps and diffusion kurtosis (DK) maps corresponding to spinal cord cross sections at C2–C3 intervertebral disc level (control) and at the most stenotic levels were obtained. Modified Japanese Orthopaedic Association (mJOA) scoring was used for clinical assessment of the spinal cord function. The changes in DTI and DKI parameters and their correlation with mJOA scores were analysed by SPSS 23 software.

Results

In our study, mean FA and mean kurtosis (MK) values at the stenotic level (0.54, 1.02) were significantly lower than values at the non-stenotic segment (0.70, 1.27). The mean diffusivity (MD) value at the stenotic segment (1.25) was significantly higher than in the non-stenotic segment (1.09). We also observed a strong positive correlation between mJOA score and FA and MK values and a negative correlation between mJOA score and MD values, suggesting a correlation of FA, MK, and MD with the clinical severity of the disease.

Conclusion

Addition of DTI and DKI sequences helps in early identification of the disease without any additional cost incurred by the patient.

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Acknowledgements

To Department of Neurosurgery.

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Authors and Affiliations

  1. Department of Radiology, All India Institute of Medical Sciences, Rishikesh, 249203, India

    Shailvi Singhal, Sonal Saran & Sudhir Saxena

  2. Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, India

    Ajeet Singh Bhadoria

  3. MR Application predevelopment, Siemens Healthcare, Erlangen, Germany

    Robert Grimm

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  1. Shailvi Singhal
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  2. Sonal Saran
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  3. Sudhir Saxena
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  4. Ajeet Singh Bhadoria
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Corresponding author

Correspondence to Sonal Saran.

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Singhal, S., Saran, S., Saxena, S. et al. Role of diffusion kurtosis imaging in evaluating microstructural changes in spinal cord of patients with cervical spondylosis. Eur Spine J 32, 986–993 (2023). https://doi.org/10.1007/s00586-023-07559-x

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  • DOI: https://doi.org/10.1007/s00586-023-07559-x

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