Functional Assessment of Lumbar Nerve Roots Using Coronal-plane Single-shot Turbo Spin-echo Diffusion Tensor Imaging

Area of Science:

• Radiology
• Neuroimaging
• Medical Physics

Background:

• Lumbar spinal stenosis can cause debilitating neurological symptoms.
• Identifying the specific affected nerve root is crucial for effective treatment.
• Current diagnostic methods may have limitations in pinpointing the exact nerve root.

Purpose of the Study:

• To evaluate the utility of diffusion tensor imaging using single-shot turbo spin-echo sequence (TSE-DTI) for identifying the responsible nerve root in patients with lumbar spinal stenosis.
• To assess the diagnostic accuracy of fractional anisotropy (FA) measurements in differentiating symptomatic from asymptomatic nerve roots.

Main Methods:

• Diffusion tensor imaging (TSE-DTI) was performed on five patients with bilateral lumbar spinal stenosis and unilateral neurological symptoms.
• Multipoint measurements of fractional anisotropy (FA) values were obtained within the spinal canal.
• FA values were compared between the symptomatic and asymptomatic sides.

Main Results:

• Fractional anisotropy (FA) values were consistently lower on the symptomatic side compared to the asymptomatic side in the spinal canal.
• TSE-DTI demonstrated the ability to distinguish between affected and unaffected nerve roots based on FA values.

Conclusions:

• TSE-DTI, combined with multipoint FA measurements, is a valuable tool for detecting the responsible nerve root in lumbar spinal stenosis.
• This neuroimaging technique can aid in differentiating the affected side, guiding clinical management.