Artikel
Dynamic flexion-extension diffusion-tensor weighted imaging of the cervical spine: A prospective feasibility study
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Autoren
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Bawarjan Schatlo
- Department of Neuroradiology, Kantonsspital Aarau, Switzerland; Department of Neurosurgery, Kantonsspital Aarau, Switzerland; Department of Neurosurgery, University Medicine Göttingen, Georg-August University, Germany
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Luca Remonda
- Department of Neuroradiology, Kantonsspital Aarau, Switzerland
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Javier Fandino
- Department of Neurosurgery, Kantonsspital Aarau, Switzerland
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Veit Rohde
- Department of Neurosurgery, University Medicine Göttingen, Georg-August University, Germany
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Ali-Reza Fathi
- Department of Neurosurgery, Kantonsspital Aarau, Switzerland
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Jatta Berberat
- Department of Neuroradiology, Kantonsspital Aarau, Switzerland
| Veröffentlicht: | 2. Juni 2015 |
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Gliederung
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Objective: In compressive cervical myelopathy magnetic resonance imaging (MRI) in neck flexion or extension reveals T2-weighted signal changes which are not apparent in the neutral position. Furthermore, diffusion tensor imaging (DTI) has been reported to show a higher sensitivity than conventional T2-weighted imaging for the detection of myelopathy. In this study, the feasibility and reproducibility of dynamic flexion-extension DTI in the cervical spinal cord was assessed in healthy volunteers.
Method: Eleven healthy volunteers were enrolled in the study. A cervical spine examination with T2 and DTI sequences was performed using a 3T MRI-scanner. The examination was then repeated in maximum neck flexion-extension. Fractional anisotropy (FA) and apparent diffusion coefficients (ADC) were calculated and compared between the extended, neutral and flexed neck positions. Measurements are provided as mean ± SD.
Results: The average range of motion within extension-flexion was 54.7 ± 11.3°. Spinal canal diameters were smaller in extension (11 ± 2mm) compared to neutral position (12 ± 2mm) and flexion (12 ± 2mm; p<0.01) especially in segments C4/5 and C5/6. Respective FA and ADC values at C4/5 in flexion (649 ± 77; 1256 ± 116), neutral position (651 ± 55; 1242 ± 111) and extension (653 ± 65; 1208 ± 148) did not differ significantly, respectively.
Conclusions: Flexion-extension DTI of the cervical spine was well tolerated in healthy volunteers. Moreover, FA and ADC values were reproducible and correlated well when compared between flexion, neutral position and extension. The technical feasibility and reproducibility of dynamic DTI encourages a trial in patients with cervical spondylotic myelopathy.
