title: Diffusion tensor imaging and fiber tractography in cervical compressive myelopathy: preliminary results.
abstract: OBJECTIVE
  To assess diffusion tensor imaging (DTI) parameters in cervical compressive myelopathy (CCM) patients compared to normal volunteers, to relate them with myelopathy severity, and to relate tractography patterns with postoperative neurologic improvement.
  
  
  METHODS
  Twenty patients suffering from CCM were prospectively enrolled (M:F = 13:7, mean age, 49.6 years; range 22-67 years) from September 2009 to March 2010. Sensitivity encoding (SENSE) single-shot echo-planar imaging (EPI) was used for the sagittal DTI. Twenty sex- and age-matched normal volunteers underwent the same scanning procedure. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values in the spinal cord were compared between the patients and normal volunteers and were related to myelopathy severity based on Japanese Orthopedic Association (JOA) scores. Tractography patterns were related to myelopathy severity and postoperative improvement.
  
  
  RESULTS
  There were significant differences between patients and normal volunteers in terms of FA (0.498 ± 0.114 vs. 0.604 ± 0.057; p = 0.001) and ADC (1.442 ± 0.389 vs. 1.169 ± 0.098; p = 0.001). DTI parameters and tractography patterns were not related to myelopathy severity. In ten patients in the neurologically worse group, postoperative neurologic improvement was seen in four of five patients with intact fiber tracts, but only one of five patients with interrupted fiber tracts exhibited neurologic improvement.
  
  
  CONCLUSIONS
  DTI parameters in CCM patients were significantly different from those in normal volunteers but were not significantly related to myelopathy severity. The patterns of tractography appear to correlate with postoperative neurologic improvement.
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, 300 Gumidong, Bundag-Gu, Seong Nam, Gyeongi-do 463-707, Korea.
authors.forename: Joon Woo
authors.initials: JW
authors.lastname: Lee
authors.forename: Jae Hyoung
authors.initials: JH
authors.lastname: Kim
authors.forename: Jong Bin
authors.initials: JB
authors.lastname: Park
authors.forename: Kun Woo
authors.initials: KW
authors.lastname: Park
authors.forename: Jin S
authors.initials: JS
authors.lastname: Yeom
authors.forename: Guen Young
authors.initials: GY
authors.lastname: Lee
authors.forename: Heung Sik
authors.initials: HS
authors.lastname: Kang
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013117:Spinal Cord Compression / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult