title: New diffusion metrics for spondylotic myelopathy at an early clinical stage.
abstract: OBJECTIVE
  To investigate the use of root mean square displacement (RMSD) and mean diffusional kurtosis (DK) metrics of q-space imaging data to estimate spinal cord compression in patients with early cervical spondylosis.
  
  
  METHODS
  We studied 50 consecutive patients at our institution (22 male, 28 female; mean age 58 years; age range 20-86 years) who had clinical signs and symptoms suggestive of early clinical stage cervical myelopathy. After conventional magnetic resonance (MR) imaging, diffusion tensor and q-space image data were acquired using 3-T MR imaging. Fractional anisotropy (FA), apparent diffusion coefficient (ADC), RMSD and mean DK values were calculated and compared between compressed and uncompressed spinal cords.
  
  
  RESULTS
  FA and mean DK values were significantly lower and RMSD was significantly higher (P = 0.0060, 0.0020 and 0.0062, respectively; Mann-Whitney U test with the Bonferroni correction) in compressed spinal cords than in uncompressed cords. ADC was also higher in compressed cords, but this difference was not statistically significant.
  
  
  CONCLUSIONS
  In the evaluation of spinal cord damage in early cervical spondylosis, mean DK and RMSD values in the spinal cord may be highly sensitive indicators of microstructural change and damage.
  
  
  CONCLUSIONS
  • Absolute surgical indications for cervical spondylosis with myelopathy remain to be established. • Diffusion tensor MRI shows abnormalities in normal-appearing but compressed spinal cord. • Non-Gaussian diffusion analysis is highly sensitive in revealing spinal cord damage.
authors.affiliation: Department of Radiology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. mahori@juntendo.ac.jp
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hori
authors.forename: Issei
authors.initials: I
authors.lastname: Fukunaga
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Masutani
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakanishi
authors.forename: Keigo
authors.initials: K
authors.lastname: Shimoji
authors.forename: Koji
authors.initials: K
authors.lastname: Kamagata
authors.forename: Koichi
authors.initials: K
authors.lastname: Asahi
authors.forename: Nozomi
authors.initials: N
authors.lastname: Hamasaki
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Shigeki
authors.initials: S
authors.lastname: Aoki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004058:Diffusion; D056324:Diffusion Tensor Imaging / Q000379:methods; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D016011:Normal Distribution; D013116:Spinal Cord / Q000473:pathology; D013117:Spinal Cord Compression / Q000473:pathology; D013118:Spinal Cord Diseases / Q000175:diagnosis* / Q000473:pathology; D013128:Spinal Osteophytosis / Q000473:pathology; D055009:Spondylosis / Q000175:diagnosis* / Q000473:pathology