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The functional relevance of diffusion tensor imaging in comparison to conventional MRI in patients with cervical compressive myelopathy

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Skeletal Radiology Aims and scope Submit manuscript

Abstract

Objective

To determine the functional relevance of diffusion tensor imaging (DTI) metrics and conventional MRI (signal intensity change in T2, compression ratio) by measuring the correlation of these parameters with clinical outcome measured by the modified Japanese Orthopedic Association (mJOA) score.

Materials and methods

A total of 20 cervical myelopathy (CM) patients participated in this prospective cohort study. The severities of CM were assessed using the mJOA score. Conventional MRIs (T2-weighted images) measuring the signal changes of spinal cords and the degree of compression at the lesion level and DTI metrics [fractional anisotropy (FA), apparent diffusion coefficient (ADC)] at each lesion and below each lesion (C7/T1) level were acquired using a 3-T Achieva MRI. These parameters were correlated with the mJOA scores to determine the functional relevance.

Results

Ninety percent of CM patients showed signal changes and 30 % of patients noted a more than 40% canal compression ratio in conventional MRIs at the lesion level; however, these findings were not correlated with the mJOA score (p < 0.05). In contrast, FA values on DTI showed high sensitivity to CM (100%), which was well correlated with the mJOA score (p = 0.034, r = 0.475) below the lesion level (C7/T1).

Conclusions

This study showed a meaningful symptomatic correlation between mJOA scores and FA values below the lesion levels in CM patients. It could give us more understanding of the pathological changes in spinal cords matched with various clinical findings in CM patients than the results from conventional MRI.

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Authors and Affiliations

  1. Spine Center, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, 896 Pyeongchon-dong, Dongan-gu, Anyang-si, Gyeonggi-do, 431-070, South Korea

    Young-Mi Yang, Jae-Keun Oh, Ji-Sun Song & Seok Woo Kim

  2. Department of Physical Medicine and Rehabilitation, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang-si, South Korea

    Woo-Kyoung Yoo

  3. Hallym Institute for Translational Genomics & Bioinformatics, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang-si, South Korea

    Woo-Kyoung Yoo

  4. Department of Orthopaedic surgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang-si, South Korea

    Je Hyun Yoo, Yoon Hae Kwak & Seok Woo Kim

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  1. Young-Mi Yang
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  2. Woo-Kyoung Yoo
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Correspondence to Seok Woo Kim.

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Conflict of interest

This study was supported by Hallym University Research Fund (HRF-01-2010-13) and the National Research Foundation of Korea (2015R1D1A1A01061562, 2013R1A1A2012562).

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Yang, YM., Yoo, WK., Yoo, J.H. et al. The functional relevance of diffusion tensor imaging in comparison to conventional MRI in patients with cervical compressive myelopathy. Skeletal Radiol 46, 1477–1486 (2017). https://doi.org/10.1007/s00256-017-2713-7

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  • DOI: https://doi.org/10.1007/s00256-017-2713-7

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