title: Magnetic resonance diffusion tensor imaging in patients with cervical spondylotic spinal cord compression: correlations between clinical and electrophysiological findings.
abstract: METHODS
  A prospective study evaluating a cohort of patients with spondylotic cervical spine compression.
  
  
  OBJECTIVE
  To analyze the potential of diffusion tensor imaging (DTI) of the cervical spinal cord in the detection of changes associated with spondylotic myelopathy, with particular reference to clinical and electrophysiological findings.
  
  
  BACKGROUND
  Conventional magnetic resonance imaging (MRI) may provide confusing findings because of a frequent disproportion between the degree of the spinal cord compression and clinical symptoms. The DTI is known to be more sensitive to subtle pathological changes of the spinal cord compared with conventional MRI.
  
  
  METHODS
  The DTI of the cervical spinal cord was performed within a group of 52 patients with spondylotic spinal cord compression and 13 healthy volunteers on a 1.5-T MRI scanner. All patients underwent clinical examination that differentiated between asymptomatic and symptomatic myelopathy subgroups, and 45 patients underwent electrophysiological examination. We measured the apparent diffusion coefficient and fractional anisotropy of the spinal cord at C2/C3 level without compression and at the maximal compression level (MCL). Sagittal spinal canal diameter, cross-sectional spinal cord area, and presence of T2 hyperintensity at the MCL were also recorded. Nonparametric statistical testing was used for comparison of controls with subgroups of patients.
  
  
  RESULTS
  Significant differences in both the DTI parameters measured at the MCL, between patients with compression and control group, were found, while no difference was observed at the noncompression level. Moreover, fractional anisotropy values were lower and apparent diffusion coefficient values were higher at the MCL in the symptomatic patients than in the asymptomatic patients. The DTI showed higher potential to discriminate between clinical subgroups in comparison with standard MRI parameters and electrophysiological findings.
  
  
  CONCLUSIONS
  The DTI appears to be a promising imaging modality in patients with spondylotic spinal cord compression. It reflects the presence of symptomatic myelopathy and shows considerable potential for discriminating between symptomatic and asymptomatic patients.
authors.affiliation: Department of Radiology, University Hospital, Brno and Masaryk University, Brno, Czech Republic.
authors.forename: Miloš
authors.initials: M
authors.lastname: Kerkovský
authors.forename: Josef
authors.initials: J
authors.lastname: Bednarík
authors.forename: Ladislav
authors.initials: L
authors.lastname: Dušek
authors.forename: Andrea
authors.initials: A
authors.lastname: Sprláková-Puková
authors.forename: Igor
authors.initials: I
authors.lastname: Urbánek
authors.forename: Marek
authors.initials: M
authors.lastname: Mechl
authors.forename: Vlastimil
authors.initials: V
authors.lastname: Válek
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Kadanka
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000473:pathology* / Q000503:physiopathology; D056324:Diffusion Tensor Imaging / Q000379:methods*; D019054:Evoked Potentials, Motor / Q000502:physiology; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013116:Spinal Cord / Q000473:pathology*; D013117:Spinal Cord Compression / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D055009:Spondylosis / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology