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67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12. - 15. Juni 2016, Frankfurt am Main

Clinical application of 3-Tesla diffusor tensor imaging DTI and fiber tracking in the spine

Meeting Abstract

  • Sami Ridwan - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Germany
  • Alina Jurcoane - Funktionseinheit Neuroradiologie, Radiologische Klinik, Universitätsklinikum Bonn, Germany
  • Elke Hattingen - Funktionseinheit Neuroradiologie, Radiologische Klinik, Universitätsklinikum Bonn, Germany
  • Hartmut Vatter - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Germany
  • Erdem Güresir - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocDI.20.07

doi: 10.3205/16dgnc225, urn:nbn:de:0183-16dgnc2252

Veröffentlicht: 8. Juni 2016

© 2016 Ridwan et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: To highlight the clinical application of diffusion tensor imaging (DTI) in different pathologies of the spine. We evaluated the severity of spinal cord injury by observing the variations of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) along the spinal cord, in relation to the lesion site. We then interpreted these variations in relation to clinical pathology. It is known that FA values are highest in the cervical spine and decrease along the spinal cord, a significant reduction is found in patients with spinal cord injury compared to control subjects. Changes of ADC values are less conclusive.

Method: The DTI data was acquired in 5 patients and a healthy control using intraoperative 3 T MRI (MR750w 3T MR-System, GE-Healthcare) with a sagittal FOCUS DTI sequence with b = 0.600 s/mm2, 12 gradient directions. We calculated FA and ADC with the Diffusion Toolkit (http://trackvis.org). On one sagittal slice of the b=0 image, we manually delineated (with FSL http://fsl.fmrib.ox.ac.uk) the entire clearly visible spinal cord as a region of interest (ROI) and we extracted FA and ADC axially along this ROI to generate a spinal cord parameter profile.

Results: Along the spinal cord of the control subject we observed relatively stable FA and more variable ADC values. Five patients with degenerative stenosis, disc prolaps, malignant epidural spinal cord compression, intramedullary cyst and intramedullary tumor were scanned. Only two patients presented with neurologic symptoms, these showed reduction of FA values at the level of compression. The remaining patients showed compression without symptoms and with slight to no FA changes. ADC seemed to behave controversially, changes occurred in two patients, one of which was asymptomatic but with relevant compression.

Conclusions: Recent improvements of DTI provide feasible spinal DTI at 3 T. FA values seem to be clinically more relevant. The clinical impact as means of predicting functional outcome appears to be realistic. However, further validations of diagnostic value and methodical reliability are needed.