gms | German Medical Science

64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. - 29. Mai 2013, Düsseldorf

Precision of diffusion tensor imaging in early detection of cervical spondylotic myelopathy: Experiences in 1.5-T MRI

Meeting Abstract

  • Uzeyir Ahmadli - Department of Neuroradiology, University Hospital, University of Zurich, Switzerland
  • Nils H. Ulrich - Department of Neuroradiology, University Hospital, University of Zurich, Switzerland; Department of Neurosurgery, University Hospital, University of Zurich, Switzerland
  • Johannes Sarnthein - Department of Neurosurgery, University Hospital, University of Zurich, Switzerland
  • Spyros S. Kollias - Department of Neuroradiology, University Hospital, University of Zurich, Switzerland

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocP 110

doi: 10.3205/13dgnc527, urn:nbn:de:0183-13dgnc5275

Veröffentlicht: 21. Mai 2013

© 2013 Ahmadli et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Cervical spondylotic myelopathy (CSM) benefits from timely radiological diagnosis with prompt treatment because surgery performed at early stages was reported to have better outcome. The intention of our study was to investigate the usefulness of Diffusion Tensor Imaging (DTI) for early radiological detection of pathological alterations in cervical myelon in patients without T2 signal hyperintensity but with narrowed cervical spinal canal (SC).

Method: DTI was performed on 18 patients with signs of CSM. Quantitative Fractional Anisotropy (FA) and Apparent Diffusion Coefficient (ADC) maps were generated on axial plane at the most narrowed cervical levels using 1.5-T MRI and compared to non-stenotic levels. We also documented the cervical canal stenosis-grade and the width of the spinal canal in the axial plane.

Results: FA was statistically reduced at the stenotic level compared to pre-stenotic (p<0.001, paired t-test). Our results failed to show statistically significant lower FA at stenotic level in comparison with post-stenotic level (p=0.5). While mean FA at pre-stenotic level was 0.51, which was statistically higher than at stenotic level (0.44), our results failed to show statistically significant increment in ADC values at stenotic level in comparison to non-stenotic levels, most probably suggesting very early stage of degeneration. Over the group of patients, ADC correlated significantly with the width of the spinal canal at the pre-stenotic level (r=0.5, p=0.03), but not at the post-stenotic level (p=0.4).

Conclusions: Our findings suggest that DTI seems to be robust to show alterations at molecular level in the spinal cord before possible pathological T2 signal hyperintensity and marked clinical worsening appears. Therefore, larger and long-term studies should be conducted to further establish the potential of DTI scalar metrics as possible biomarkers in patients with clinical signs of CSM to detect and intervene earlier for a better clinical outcome.