Related Experiment Video
Updated: May 2, 2026
Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression
Published on: May 7, 2019
Diffusion tensor imaging predicts functional impairment in mild-to-moderate cervical spondylotic myelopathy
Benjamin M Ellingson1, Noriko Salamon2, John W Grinstead3
1Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Blvd., Suite 615, Los Angeles, CA 90024, USA; Department of Biomedical Physics, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Blvd., Suite 615, Los Angeles, CA 90024, USA; Department of Bioengineering, School of Engineering, University of California Los Angeles, 420 Westwood Plaza, 5121 Engineering V, Los Angeles, CA 90095, USA.
Background Context:
Magnetic resonance imaging (MRI) is the standard imaging modality for the assessment of cervical spinal cord; however, MRI assessment of the spinal cord in cervical spondylotic myelopathy patients has not demonstrated a consistent association with neurologic function or outcome after surgical or medical intervention. Thus, there is a need for sensitive imaging biomarkers that can predict functional impairment in patients with advanced cervical spondylosis.
Purpose:
To implement diffusion tensor imaging (DTI) as an imaging biomarker for microstructural integrity and functional impairment in patients with cervical spondylosis.
Study Design:
Nonrandomized, single institution study.
Patient Sample:
Forty-eight cervical spondylosis patients with or without spinal cord signal change underwent DTI of the spinal cord along with functional assessment.
Outcome Measures:
Functional measures of neurologic function via modified Japanese Orthopedic Association (mJOA) score.
Methods:
A zoomed-echoplanar imaging technique and two-dimensional spatially selective radiofrequency excitation pulse were used for DTI measurement. Fractional anisotropy (FA), mean diffusivity (MD), radial and axial diffusion (AD) coefficient, AD anisotropy, ψ, defined as AD-MD, and the standard deviation (SD) of primary eigenvector orientation were evaluated at the site of compression.
Results:
Results suggest average FA, transverse apparent diffusion coefficient, ψ, and SD of primary eigenvector orientation at the spinal level of highest compression were linearly correlated with mJOA score. Receiver-operator characteristic analysis suggested FA and ψ could identify stenosis patients with mild-to-moderate symptoms with a relatively high sensitivity and specificity.
Conclusions:
The results of this study support the potential use of DTI as a biomarker for predicting functional impairment in patients with cervical spondylosis.
