title: Diffusion-weighted MR imaging with apparent diffusion coefficient and apparent diffusion tensor maps in cervical spondylotic myelopathy.
abstract: OBJECTIVE
  To evaluate diffusion-weighted magnetic resonance (MR) imaging in patients with cervical spondylosis and/or myelopathy.
  
  
  METHODS
  A multishot echo-planar imaging sequence with calculation of apparent diffusion coefficient (ADC) and apparent diffusion tensor (ADT) was applied in 36 patients with symptomatic cervical spondylosis. Diffusion-weighted images read by two neuroradiologists were compared with T2-weighted fast spin-echo images read independently by three neuroradiologists with regard to clinical status (n = 36). MR findings in a selected subgroup of 20 patients whose clinical status was confirmed by electrophysiologic examination also were compared. Sensitivity, specificity, positive predictive value, and negative predictive value of both T2-weighted imaging and diffusion-weighted imaging (ADC and ADT) were calculated and compared.
  
  
  RESULTS
  Patients with myelopathy had abnormal ADC (17 of 21) and ADT (15 of 19) maps with increased ADC and ADT values and decreased anisotropy. For the detection of myelopathy, diffusion-weighted ADC maps had a sensitivity of 80% (17 of 21), while T2-weighted images had a sensitivity of 61% (13 of 21). The negative predictive value was 63% (seven of 11) and 60% (12 of 20) for ADC maps and T2-weighted images, respectively. Conversely, the specificity of diffusion-weighted images (53%; seven of 13) was lower than that of T2-weighted images (92%; 12 of 13). In patients with myelopathy confirmed at electrophysiologic examination, the sensitivity of diffusion-weighted images increased to 92% (12 of 13) and the negative predictive value increased to 75% (three of four), while T2-weighted images had a 53% (seven of 13) sensitivity and a 50% (six of 12) negative predictive value.
  
  
  CONCLUSIONS
  Diffusion weighting improved the sensitivity of imaging in cervical spondylotic myelopathy.
authors.affiliation: Department of Neuroradiology, CHU-Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux, France.
authors.forename: Ayhan
authors.initials: A
authors.lastname: Demir
authors.forename: Mario
authors.initials: M
authors.lastname: Ries
authors.forename: Crit T W
authors.initials: CT
authors.lastname: Moonen
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Vital
authors.forename: Joël
authors.initials: J
authors.lastname: Dehais
authors.forename: Pierre
authors.initials: P
authors.lastname: Arne
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Caillé
authors.forename: Vincent
authors.initials: V
authors.lastname: Dousset
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D017352:Echo-Planar Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013116:Spinal Cord / Q000473:pathology; D013117:Spinal Cord Compression / Q000175:diagnosis* / Q000209:etiology; D013128:Spinal Osteophytosis / Q000175:diagnosis*