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Diffusion tensor imaging in the cervical spinal cord

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Abstract

There are discrepancy between MR findings and clinical presentations. The compressed cervical cord in patients of the spondylotic myelopathy may be normal on conventional MRI when it is at the earlier stage or even if patients had severe symptoms. Therefore, it is necessary to take a developed MR technique—diffusion tensor imaging (DTI)—to detect the intramedullary lesions. Prospective MR and DTI were performed in 53 patients with cervical compressive myelopathy and twenty healthy volunteers. DTI was performed along six non-collinear directions with single-shot spin echo echo-planar imaging (EPI) sequence. Intramedullary apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values were measured in four segments (C2/3, C3/4, C4/5, C5/6) for volunteers, in lesions (or the compressed cord) and normal cord for patients. DTI original images were processed to produce color DTI maps. In the volunteers’ group, cervical cord exhibited blue on the color DTI map. FA values between four segments had a significant difference (P < 0.01), with the highest FA value (0.85 ± 0.03) at C2/3 level. However, ADC value between them had no significant difference (P > 0.05). For patients, only 24 cases showed hyperintense on T2-weighted image, while 39 cases shown patchy green signal on color DTI maps. ADC and FA values between lesions or the compressed cord and normal spinal cord of patients had a significant difference (both P < 0.01). FA value at C2/3 cord is the highest of other segments and it gradually decreases towards the caudal direction. Using single-shot spin echo EPI sequence and six non-collinear diffusion directions with b value of 400 s mm−2, DTI can clearly show the intramedullary microstructure and more lesions than conventional MRI.

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Notes

  1. Figures 3, 4, 5, 6 are from the same patients.

  2. Figures 7, 8 are from 57-year-old patient with spondylotic compressive myelopathy.

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Acknowledgments

The manuscript submitted was supported by the Medical Science Foundation of the Department of Health of Guangdong Province (No.A2006529), the Medical Science Foundation of the Bureau of Health of Guangzhou city (No.2005-YB-040), and Doctoral Scientific Research Start-up Foundation of Guangzhou Medical College (No. 2006GD081). No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

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Authors and Affiliations

  1. Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, No. 63 Duobao Road, Guangdong, 510150, Guangzhou, China

    Ting Song, Wen-Jun Chen, Jian-Wei Huang, Ming-Jin Cai, Tian-Fa Dong & Tang-Sheng Li

  2. Department of Orthopedics, The Third Affiliated Hospital of Guangzhou Medical University, No. 63 Duobao Road, Guangdong, 510150, Guangzhou, China

    Bo Yang & Hong-Pu Zhao

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  1. Ting Song
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Correspondence to Ting Song.

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Song, T., Chen, WJ., Yang, B. et al. Diffusion tensor imaging in the cervical spinal cord. Eur Spine J 20, 422–428 (2011). https://doi.org/10.1007/s00586-010-1587-3

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