Diffusion tensor imaging and fibre tracking in cervical spondylotic myelopathy

Area of Science:

• Neuroimaging
• Spinal Cord Imaging
• Diffusion Tensor Imaging

Background:

• Cervical spondylotic myelopathy (CSM) is a degenerative condition affecting the cervical spinal cord.
• Assessing spinal cord microstructural changes in CSM is crucial for diagnosis and management.
• Conventional MRI sequences may not fully capture the extent of neural damage.

Purpose of the Study:

• To obtain microstructural parameters (Fractional Anisotropy: FA, Mean Diffusivity: MD) of the cervical spinal cord in CSM patients using tractography.
• To compare DTI parameters with clinical assessments and conventional MRI findings in CSM.
• To evaluate the diagnostic sensitivity of FA compared to T2-weighted imaging.

Main Methods:

• Diffusion Tensor Imaging (DTI) was performed on 20 CSM patients and 15 healthy volunteers.
• FA and MD values were calculated from tractography at specific cervical spinal cord levels.
• Clinical evaluation of patients was conducted using a self-administered questionnaire.

Main Results:

• CSM patients exhibited significantly lower FA values at compressed spinal cord levels compared to controls.
• A significant positive correlation was found between FA at compressed levels and clinical assessment scores.
• Increased signal intensity on T2-weighted images did not correlate with FA, MD, or clinical scores.

Conclusions:

• FA values are significantly correlated with clinical scores in CSM patients.
• FA is more sensitive in detecting spinal cord alterations in CSM than T2 signal intensity.
• DTI-derived FA shows promise as a sensitive biomarker for assessing spinal cord damage in CSM.