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The apparent diffusion coefficient based on small-field DWI is superior to T2-weighted imaging in evaluating neurological dysfunction of degenerative cervical myelopathy

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Abstract

Purpose

To investigate the clinical application of zonally magnified oblique multislice (ZOOM) imaging technology in patients with degenerative cervical myelopathy (DCM) and compare it with T2WI imaging.

Methods

A total of 111 patients diagnosed with DCM were recruited. According to mJOA, patients with DCM were divided into ND + group with neurological dysfunction and ND- group without neurological dysfunction. Routine MRI and ZOOM-DWI were performed on 3.0 T MRI to obtain sagittal T2WI and apparent diffusion coefficient (ADC) diagram. ADC values of the narrow segment and its adjacent upper and lower segments were measured, and compared between the ND + and ND- groups. The correlation between ADC value of cervical spinal cord and mJOA score was analyzed. Additionally, ROC curves were plotted to calculate the AUC values.

Results

The comparison between ND + and ND– groups shows that there are significant differences in mJOA score, T2WI, anteroposterior diameter of spinal canal, ADC values of narrow, upper and lower segment (P < 0.05). In ND + group, there is a significant difference between ADC values of the narrow and its upper and lower segments (P < 0.001), while with no significant difference in ADC values of the upper and lower segments (P > 0.05). Results of correlation analysis indicate that in the ND + group, neurological dysfunction evaluated by mJOA scores is correlated with increased ADC values of the narrow segment (r = –0.52, P < 0.001), but not significantly correlated with ADC values of the upper and lower segments. Furthermore, T2WI, anteroposterior diameter of the spinal canal, and cervical cord ADC values all has diagnostic efficacy in evaluating neurological dysfunction in DCM (AUC > 0.5, P < 0.05), with the ADC value of the narrow segment being optimal.

Conclusion

The ADC value of spinal cord obtained by small-field ZOOM-DWI can be used to evaluate neurological dysfunction in DCM, and is superior to traditional T2WI.

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References

  1. Boden SD et al (1990) Abnormal magnetic-resonance scans of the cervical spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am 72(8):1178–1184

    Article  CAS  PubMed  Google Scholar 

  2. Saunders LM et al (2023) Degenerative cervical myelopathy: an overview. Cureus 15(12):e50387

    PubMed  PubMed Central  Google Scholar 

  3. Davies BM et al (2018) Degenerative cervical myelopathy. BMJ 360:k186

    Article  PubMed  PubMed Central  Google Scholar 

  4. Valošek J et al (2022) Quantitative MR markers in non-myelopathic spinal cord compression: a narrative review. J Clin Med 11(9):2301

    Article  PubMed  PubMed Central  Google Scholar 

  5. Akshiitha JR et al (2022) The role of diffusion tensor tractography in assessment of spondylotic myelopathy. Cureus 14(6):e25778

    Google Scholar 

  6. Mohammadi, M., et al., 2024 Correlation Between Pre-Operative Diffusion Tensor Imaging Indices and Post-Operative Outcome in Degenerative Cervical Myelopathy: A Systematic Review and Meta-Analysis. Global Spine J, 21925682231225634

  7. Ellingson BM, Salamon N, Holly LT (2015) Advances in MR imaging for cervical spondylotic myelopathy. Eur Spine J 242(2):197–208

    Article  Google Scholar 

  8. Nukala M et al (2019) Efficacy of diffusion tensor imaging in identification of degenerative cervical spondylotic myelopathy. Eur J Radiol Open 6:16–23

    Article  PubMed  Google Scholar 

  9. Zaharchuk G et al (2011) Reduced field-of-view diffusion imaging of the human spinal cord: comparison with conventional single-shot echo-planar imaging. Ajnr Am J Neuroradiol 32(5):813–820

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Wilm BJ et al (2009) Diffusion-weighted imaging of the entire spinal cord. NMR Biomed 22(2):174–181

    Article  CAS  PubMed  Google Scholar 

  11. Banerjee S et al (2016) Reduced field-of-view DWI with robust fat suppression and unrestricted slice coverage using tilted 2D RF excitation. Magn Reson Med 76(6):1668–1676

    Article  CAS  PubMed  Google Scholar 

  12. Tetreault L et al (2016) Predicting the minimum clinically important difference in patients undergoing surgery for the treatment of degenerative cervical myelopathy. Neurosurg Focus 40(6):E14

    Article  PubMed  Google Scholar 

  13. Yu Z et al (2022) Application of electrophysiological measures in degenerative cervical myelopathy. Front Cell Dev Biol 10:834668

    Article  PubMed  PubMed Central  Google Scholar 

  14. Green C et al (2012) Imaging modalities for cervical spondylotic stenosis and myelopathy. Adv Orthop 2012:908324

    Article  CAS  PubMed  Google Scholar 

  15. Khan AF et al (2023) Utility of MRI in quantifying tissue injury in cervical spondylotic myelopathy. J Clin Med 12(9):3337

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Martin AR et al (2022) Imaging and electrophysiology for degenerative cervical myelopathy [AO spine Recode-DCM research priority number 9]. Global Spine J 12(1):130–146

    Article  Google Scholar 

  17. Shabani, S., et al., 2020 Diffusion tensor imaging in cervical spondylotic myelopathy: a review. J Neurosurg Spine, 1–8

  18. Jiang W et al (2018) Usefulness of conventional magnetic resonance imaging, diffusion tensor imaging and neurite orientation dispersion and density imaging in evaluating postoperative function in patients with cervical spondylotic myelopathy. J Orthop Translat 15:59–69

    Article  PubMed  PubMed Central  Google Scholar 

  19. By S et al (2017) Application and evaluation of NODDI in the cervical spinal cord of multiple sclerosis patients. Neuroimage Clin 15:333–342

    Article  PubMed  PubMed Central  Google Scholar 

  20. Zhang MZ et al (2022) Utility of advanced dwi in the detection of spinal cord microstructural alterations and assessment of neurologic function in cervical spondylotic myelopathy patients. J Magn Reson Imaging 55(3):930–940

    Article  PubMed  Google Scholar 

  21. Alizadeh M et al (2018) Zonally magnified oblique multislice and non-zonally magnified oblique multislice DWI of the cervical spinal cord. Ajnr Am J Neuroradiol 39(8):1555–1561

    CAS  PubMed  PubMed Central  Google Scholar 

  22. Wheeler-Kingshott CA et al (2002) ADC mapping of the human optic nerve: increased resolution, coverage, and reliability with CSF-suppressed ZOOM-EPI. Magn Reson Med 47(1):24–31

    Article  PubMed  Google Scholar 

  23. Mamata H, Jolesz FA, Maier SE (2005) Apparent diffusion coefficient and fractional anisotropy in spinal cord: age and cervical spondylosis-related changes. J Magn Reson Imaging 22(1):38–43

    Article  PubMed  Google Scholar 

  24. Guan X et al (2015) Diffusion tensor imaging studies of cervical spondylotic myelopathy: a systemic review and meta-analysis. PLoS ONE 10(2):e0117707

    Article  PubMed  PubMed Central  Google Scholar 

  25. David G et al (2019) Traumatic and nontraumatic spinal cord injury: pathological insights from neuroimaging. Nat Rev Neurol 15(12):718–731

    Article  PubMed  Google Scholar 

  26. Demir A et al (2003) Diffusion-weighted MR imaging with apparent diffusion coefficient and apparent diffusion tensor maps in cervical spondylotic myelopathy. Radiology 229(1):37–43

    Article  PubMed  Google Scholar 

Download references

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Author notes

  1. Xiao-nan Tian and Sheng-Nan Li contributed equally to this work.

Authors and Affiliations

  1. Department of CTMRI, The Third Hospital of HeBei Medical University, ShijiaZhuang, 050051, China

    Xiao-Nan Tian

  2. Department of Radiology and Nuclear Medicine, The First Hospital of HeBei Medical University, No. 89 Donggang Road, ShijiaZhuang, 050000, China

    Sheng-Nan Li, Bao-Gen Zhao, Ning Wang, Ting Gao & Li Zhang

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  1. Xiao-Nan Tian
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Correspondence to Li Zhang.

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The authors have no potential conflicts of interest.

Ethical approval

This study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the Third Hospital of Hebei Medical UniversityEthical number: W2022-027–1.

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Tian, XN., Li, SN., Zhao, BG. et al. The apparent diffusion coefficient based on small-field DWI is superior to T2-weighted imaging in evaluating neurological dysfunction of degenerative cervical myelopathy. Eur Spine J (2024). https://doi.org/10.1007/s00586-024-08411-6

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  • DOI: https://doi.org/10.1007/s00586-024-08411-6

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