title: Clinical relevance of diffusion tensor imaging parameters in lumbar disco-radicular conflict.
abstract: OBJECTIVE
  To measure the fractional anisotropy (FA) and the mean diffusivity (MD) values of L4, L5 and S1 nerve roots using diffusion tensor imaging (DTI) and to correlate them with four different clinical patterns.
  
  
  METHODS
  Fifty-six human participants were prospectively included and divided between four groups: healthy subjects, patients with clinical symptomatic nerve root pain with and without anatomical discoradicular conflict and patients with incidental anatomical discoradicular conflict seen on magnetic resonance imaging (MRI). MRI protocol included anatomical sequences (sagittal T1- and T2-weighted, axial T2-weighted) and a 25 directions DTI sequence. FA and MD values were measured in consensus by two readers and compared between the four groups.
  
  
  RESULTS
  Mean FA and MD values were significantly different for patients with clinically symptomatic nerve root pain (n=27) both with (n=16) (FA=0.187±0.015; MD=510±40) and without (n=11) (FA=0.193±0.011; MD=490±30.5) anatomical discoradicular conflict compared to healthy subjects (n=29) (FA=0.221±0.011; MD=460.9±35.5) including 2 subjects with incidental anatomical discoradicular conflict (FA=0.211±0.013; MD=450.8±41.2) on MRI (P=0.003).
  
  
  CONCLUSIONS
  Measurement of FA and MD values of L4, L5 and S1 nerve roots using DTI could be useful in lumbar nerve root pain assessment. Further studies with different image processing methods are needed.
authors.affiliation: Service de Radiologie, Centre Hospitalier Universitaire Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France; Inserm U698, Centre Hospitalier Universitaire Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France; Faculté de Médecine Xavier-Bichat, Université Paris-7, Paris, France. Electronic address: benjamin.dallaudiere@gmail.com.
authors.forename: B
authors.initials: B
authors.lastname: Dallaudière
authors.affiliation: Service de Radiologie, Centre Hospitalier Universitaire Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Lincot
authors.affiliation: Service de Radiologie, Centre Hospitalier Universitaire Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France; Faculté de Médecine Xavier-Bichat, Université Paris-7, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Hess
authors.affiliation: Service de Radiologie Ostéo-Articulaire, Centre Hospitalier Régional Universitaire Roger-Salengro, Lille, France; Faculté de Médecine, Université Lille 2, Lille, France.
authors.forename: V
authors.initials: V
authors.lastname: Balbi
authors.affiliation: Service d'Imagerie Diagnostique et Interventionnelle de l'Adulte Groupe Hospitalier Pellegrin, place Amelie-Raba-Leon, 33076 Bordeaux cedex, France.
authors.forename: F
authors.initials: F
authors.lastname: Cornelis
authors.affiliation: MSK Department Imaging, Cliniques Universitaires Saint-Luc, avenue Hippocrate 10, 1200 Bruxelles, Belgique.
authors.forename: A
authors.initials: A
authors.lastname: Larbi
authors.affiliation: Service de Radiologie, Centre Hospitalier Universitaire Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France; Faculté de Médecine Xavier-Bichat, Université Paris-7, Paris, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Laissy
authors.affiliation: Service de Radiologie Ostéo-Articulaire, Centre Hospitalier Régional Universitaire Roger-Salengro, Lille, France; Faculté de Médecine, Université Lille 2, Lille, France.
authors.forename: A
authors.initials: A
authors.lastname: Cotten
authors.affiliation: Service de Radiologie, Centre Hospitalier Universitaire Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France; Faculté de Médecine Xavier-Bichat, Université Paris-7, Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Schouman-Claeys
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D017352:Echo-Planar Imaging / Q000379:methods; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007405:Intervertebral Disc Displacement / Q000175:diagnosis*; D008159:Lumbar Vertebrae / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000175:diagnosis*; D015588:Observer Variation; D011446:Prospective Studies; D012447:Sacrum / Q000473:pathology*; D012680:Sensitivity and Specificity; D013126:Spinal Nerve Roots / Q000473:pathology*
keywords: Diffusion tensor imaging; Discoradicular conflict; Lumbar; Spine; Tractography