title: Diffusion tensor imaging in musculoskeletal disorders.
abstract: Diffusion tensor (DT) imaging is an emerging magnetic resonance (MR) imaging technique for evaluating the microstructure of well-organized biologic tissues such as muscles and nerves. DT imaging provides information about tissue microstructure by producing three-dimensional maps of water molecule movements. The two main parameters of measurement at DT imaging, fractional anisotropy and the apparent diffusion coefficient, allow quantitation of architectural changes occurring in tissue. These parameters are modified in the presence of cervical spondylotic myelopathy, cervical spine trauma, carpal tunnel syndrome, lumbar nerve compression, peripheral nerve tumors, and muscle ischemia. Their alteration may be observed at DT imaging even when no abnormality is seen at conventional MR imaging, a fact that suggests that DT imaging allows the detection of abnormalities at an earlier stage of injury. Experimental studies in animals have shown that DT imaging consistently allows identification of pathophysiologic alterations in tissue that correlate with histologic findings. Tractographic images accurately depict both normal and abnormal diffusion in anatomic structures such as the thigh and pelvic muscles, cervical spine, and lumbar nerves. Patients with chronic diseases also may benefit from follow-up evaluation with DT imaging, although DT imaging sequences must be further adapted to improve the evaluation of specific anatomic regions by reducing artifacts, optimizing spatial resolution, and minimizing acquisition time. Given its proven potential for use in identifying abnormalities that are otherwise identifiable only with electrophysiologic and histopathologic studies, and with future technical improvements, DT imaging could soon become a standard method for early diagnosis, management, and follow-up of disease in the spine, muscles, and peripheral nerves.
authors.affiliation: From the Service d'Imagerie Médicale, Groupe Hospitalier de l'Institut Catholique de Lille-Faculté Libre de Médecine, Hôpital St Vincent de Paul, Boulevard de Belfort, 59020 Lille, France (J.F.B., S.V.); Service de Radiologie et Imagerie Musculosquelettique, Centre de Consultation et d'Imagerie de l'Appareil Locomoteur, CHRU de Lille, Lille, France (J.F.B., V.B., V.P., V.L.T., A.C.); Université Catholique de Lille, Lille, France (J.F.B., S.V.); Université Nord de France, Lille, France (J.F.B., V.B., S.V., V.P., V.L.T., A.C.); EA 4490 PMOI (Physiopathologie des Maladies Osseuses Inflammatoires) IFR 114 PRES Université Lille Nord de France, Lille, France (J.F.B., V.P., A.C.); and CHU Lille-INSERM U703, Lille, France (V.L.T.).
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Budzik
authors.forename: Vincent
authors.initials: V
authors.lastname: Balbi
authors.forename: Sébastien
authors.initials: S
authors.lastname: Verclytte
authors.forename: Vittorio
authors.initials: V
authors.lastname: Pansini
authors.forename: Vianney
authors.initials: V
authors.lastname: Le Thuc
authors.forename: Anne
authors.initials: A
authors.lastname: Cotten
mesh_terms: D000375:Aging / Q000473:pathology; D000818:Animals; D004058:Diffusion; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D056324:Diffusion Tensor Imaging / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008954:Models, Biological; D018485:Muscle Fibers, Skeletal / Q000473:pathology; D018482:Muscle, Skeletal / Q000098:blood supply / Q000293:injuries / Q000294:innervation / Q000473:pathology; D009140:Musculoskeletal Diseases / Q000175:diagnosis / Q000473:pathology*