Cervical Spine Prospective Feasibility Study : Dynamic Flexion-Extension Diffusion-Tensor Weighted Magnetic Resonance...

Area of Science:

• Medical Imaging
• Neuroscience
• Spinal Cord Research

Background:

• Cervical myelopathy diagnosis can be challenging.
• Diffusion Tensor Imaging (DTI) shows promise for detecting spinal cord abnormalities.
• Dynamic DTI during flexion-extension may enhance sensitivity.

Purpose of the Study:

• Assess the feasibility and reproducibility of dynamic DTI in the cervical spine.
• Evaluate DTI parameters (FA, ADC) in healthy volunteers and patients with cervical myelopathy.
• Determine if dynamic DTI can identify changes indicative of myelopathy.

Main Methods:

• Subjects underwent 3T MRI in maximum neck flexion and extension.
• Measured range of motion, spinal cord space, fractional anisotropy (FA), and apparent diffusion coefficient (ADC).
• Compared DTI metrics between neutral, flexion, and extension positions in volunteers and patients.

Main Results:

• Healthy volunteers showed no significant changes in ADC or FA.
• Patients exhibited increased ADC in diseased segments during extension compared to neutral or flexion.
• Patients showed significantly lower FA in extension at both control and affected levels.

Conclusions:

• Dynamic DTI of the cervical spine is feasible and reproducible.
• Increased ADC in extension in patients suggests potential for earlier myelopathy detection.
• This technique offers a novel approach for identifying cervical myelopathy.