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- Title
Utility of Advanced DWI in the Detection of Spinal Cord Microstructural Alterations and Assessment of Neurologic Function in Cervical Spondylotic Myelopathy Patients.
- Authors
Meng-Ze Zhang; Han-Qiang Ou-Yang; Jian-Fang Liu; Dan Jin; Chun-Jie Wang; Xian-Chang Zhang; Qiang Zhao; Xiao-Guang Liu; Zhong-Jun Liu; Ning Lang; Liang Jiang; Hui-Shu Yuan
- Abstract
Background: Diffusion-weighted imaging (DWI) can quantify the microstructural changes in the spinal cord. It might be a substitute for T2 increased signal intensity (ISI) for cervical spondylotic myelopathy (CSM) evaluation and prognosis. Purpose: The purpose of the study is to investigate the relationship between DWI metrics and neurologic function of patients with CSM. Study Type: Retrospective. Population: Forty-eight patients with CSM (18.8% females) and 36 healthy controls (HCs, 25.0% females). Field Strength/Sequence: 3 T; spin-echo echo-planar imaging-DWI; turbo spin-echo T1/T2; multi-echo gradient echo T2*. Assessment: For patients, conventional MRI indicators (presence and grades of T2 ISI), DWI indicators (neurite orientation dispersion and density imaging [NODDI]-derived isotropic volume fraction [ISOVF], intracellular volume fraction, and orientation dispersion index [ODI], diffusion tensor imaging [DTI]-derived fractional anisotropy [FA] and mean diffusivity [MD], and diffusion kurtosis imaging [DKI]-derived FA, MD, and mean kurtosis), clinical conditions, and modified Japanese Orthopaedic Association (mJOA) were recorded before the surgery. Neurologic function improvement was measured by the 3-month follow-up recovery rate (RR). For HCs, DWI, and mJOA were measured as baseline comparison. Statistical Tests: Continuous (categorical) variables were compared between patients and HCs using Student's t-tests or Mann-Whitney U tests (chi-square or Fisher exact tests). The relationships between DWI metrics/conventional MRI findings, and the pre-operative mJOA/RR were assessed using correlation and multivariate analysis. P < 0.05 was considered statistically significant. Results: Among patients, grades of T2 ISI were not correlated with pre-surgical mJOA/RR (P = 0.717 and 0.175, respectively). NODDI ODI correlated with pre-operative mJOA (r = -0.31). DTI FA, DKI FA, and NODDI ISOVF were correlated with the recovery rate (r = 0.31, 0.41, and -0.34, respectively). In multivariate analysis, NODDI ODI (DTI FA, DKI FA, NODDI ISOVF) significantly contributed to the pre-operative mJOA (RR) after adjusting for age. Data Conclusion: DTI FA, DKI FA, and NODDI ISOVF are predictors for prognosis in patients with CSM. NODDI ODI can be used to evaluate CSM severity.
- Subjects
CERVICAL spondylotic myelopathy; ECHO-planar imaging; SPINAL cord; MANN Whitney U Test; DIFFUSION tensor imaging; FUNCTIONAL assessment
- Publication
Journal of Magnetic Resonance Imaging, 2022, Vol 55, Issue 3, p930
- ISSN
1053-1807
- Publication type
Article
- DOI
10.1002/jmri.27894