title: The role of DTI in early detection of cervical spondylotic myelopathy: a preliminary study with 3-T MRI.
abstract: BACKGROUND
  The radiological diagnosis of cervical spondylotic myelopathy (CSM) has to be made as soon as possible, since surgery performed in earlier stages during the course of CSM was reported to be more successful when compared with later stages. We hypothesized that diffusion tensor imaging (DTI) may detect CSM in earlier stages, before the appearance of signal increase in T2-weighted sequences.
  
  
  METHODS
  A total of 16 patients with neurological signs and symptoms of CSM but without hyperintensity in spinal cord on T2-weighted sequences enrolled in the study. The magnetic resonance (MR) examinations were performed on a 3-T MR imaging system. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) maps were generated on axial plane. The ADC and FA measurements in each individual were made at the level of most severe cervical canal stenosis and at a nonstenotic level. Student's t test was used to compare FA and ADC values of the spinal cord in stenotic and nonstenotic segments. We also investigated if there was a correlation between DTI parametrics and duration of clinical symptoms by using Pearson correlation analysis.
  
  
  RESULTS
  All patients showed changes in DTI parametrics at stenotic segments. While FA values of the spinal cord at the stenotic level showed a statistically significant reduction, there was a statistically significant increase in the measured ADC values (p < 0.001). There was no statistical correlation between the duration of symptoms and DTI parametrics.
  
  
  CONCLUSIONS
  Our preliminary findings indicate that DTI may show abnormalities in the spinal cord before the development of T2 hyperintensity on conventional sequences in patients with CSM.
authors.affiliation: Department of Radiology, Bakirköy Dr. Sadi Konuk Teaching Hospital, Tevfik Saglam Caddesi No:11 Zuhuratbaba, Bakırköy, 34147, Istanbul, Turkey. kara_batuhan@yahoo.com
authors.forename: Batuhan
authors.initials: B
authors.lastname: Kara
authors.forename: Azim
authors.initials: A
authors.lastname: Celik
authors.forename: Selhan
authors.initials: S
authors.lastname: Karadereler
authors.forename: Levent
authors.initials: L
authors.lastname: Ulusoy
authors.forename: Kursat
authors.initials: K
authors.lastname: Ganiyusufoglu
authors.forename: Levent
authors.initials: L
authors.lastname: Onat
authors.forename: Ayhan
authors.initials: A
authors.lastname: Mutlu
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Ornek
authors.forename: Mustafa
authors.initials: M
authors.lastname: Sirvanci
authors.forename: Azmi
authors.initials: A
authors.lastname: Hamzaoglu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012019:Reflex Sympathetic Dystrophy / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013116:Spinal Cord / Q000473:pathology*