Display options
Share it on

J Craniovertebr Junction Spine. 2015 Jul-Sep;6(3):120-4. doi: 10.4103/0974-8237.161593.

Prediction of the efficacy of surgical intervention in patients with cervical myelopathy by using diffusion tensor 3T-magnetic resonance imaging parameters.

Journal of craniovertebral junction & spine

Hironori Arima, Shinichi Sakamoto, Kentaro Naito, Toru Yamagata, Takehiro Uda, Kenji Ohata, Toshihiro Takami

Affiliations

  1. Department of Neurosurgery, Osaka City University, Graduate School of Medicine, Osaka, Japan.
  2. Department of Diagnostic and Interventional Radiology, Osaka City University, Graduate School of Medicine, Osaka, Japan.
  3. Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan.

PMID: 26288547 PMCID: PMC4530511 DOI: 10.4103/0974-8237.161593

Abstract

BACKGROUND: The clinical significance of diffusion tensor (DT) magnetic resonance imaging (MRI) parameters was analyzed to predict postoperative functional recovery in patients with cervical myelopathy.

MATERIALS AND METHODS: Sixteen patients with cervical myelopathy caused by cervical spondylosis, disk herniation or ossification of the posterior longitudinal ligament who underwent surgical intervention in our institute were enrolled in this retrospective study. There were 7 men and 9 women, with a mean age of 62.8 years. Clinical assessment was done before surgery and at least 3 months after surgery. All patients underwent whole-body 3.0-Tesla MRI before surgery. DT images (DTIs) were obtained using a single-shot fast spin-echo-based sequence. Mean values of mean diffusivity (MD) and fractional anisotropy (FA) at 6 disk levels of the cervical spine were measured using manual setting of regions of interest. The MD and FA values at the most compressed part were analyzed. Absolute MD and FA values at the most compressed spinal level in patients were transformed into the normalized values with a z-score analysis.

RESULTS: MD-z may decrease with the severity of cervical myelopathy. Receiver operating characteristic analysis of MD-z and FA-z suggested that both MD-z and FA-z have clinical validity for predicting the efficacy of surgical intervention, but MD-z was considered to be the most appropriate value to predict the efficacy of surgery.

CONCLUSIONS: DTIs may be a promising modality to predict functional recovery after surgery. MD changes may reflect spinal cord condition and its reversibility.

Keywords: Cervical myelopathy; diffusion tensor parameters; fractional anisotropy; functional recovery; mean diffusivity

References

  1. J Magn Reson Imaging. 2005 Jul;22(1):38-43 - PubMed
  2. AJNR Am J Neuroradiol. 2013 Feb;34(2):471-8 - PubMed
  3. Spine (Phila Pa 1976). 2014 Jul 1;39(15):1183-9 - PubMed
  4. Eur Radiol. 2011 Feb;21(2):426-33 - PubMed
  5. NMR Biomed. 2012 May;25(5):795-805 - PubMed
  6. J Magn Reson Imaging. 1998 Jul-Aug;8(4):775-82 - PubMed
  7. Neuroradiology. 2011 Aug;53(8):609-16 - PubMed
  8. Skeletal Radiol. 2011 Dec;40(12):1543-51 - PubMed
  9. J Neurosurg. 1995 Aug;83(2):336-41 - PubMed
  10. Radiology. 2014 Jan;270(1):197-204 - PubMed
  11. J Craniovertebr Junction Spine. 2011 Jul;2(2):77-81 - PubMed
  12. J Magn Reson Imaging. 2001 Apr;13(4):534-46 - PubMed
  13. J Neurosurg Spine. 2012 Aug;17(2):147-52 - PubMed
  14. Neurol Med Chir (Tokyo). 1992 Jan;32(1):40-1 - PubMed
  15. Spine (Phila Pa 1976). 1995 Oct 15;20(20):2226-32 - PubMed
  16. Spine (Phila Pa 1976). 2012 Jan 1;37(1):48-56 - PubMed
  17. J Neuropathol Exp Neurol. 1982 Mar;41(2):129-49 - PubMed
  18. Brain. 1953 Mar;76(1):70-91 - PubMed
  19. Spine (Phila Pa 1976). 2013 Mar 1;38(5):407-14 - PubMed
  20. Magn Reson Med. 1997 Mar;37(3):387-94 - PubMed
  21. Conf Proc IEEE Eng Med Biol Soc. 2009;2009:2715-8 - PubMed
  22. J Neurosurg. 1972 Dec;37(6):631-52 - PubMed
  23. AJNR Am J Neuroradiol. 2008 Nov;29(10):1976-82 - PubMed
  24. AJNR Am J Neuroradiol. 2005 Jun-Jul;26(6):1587-94 - PubMed

Publication Types