title: Tract-Specific Diffusion Tensor Imaging in Cervical Spondylotic Myelopathy Before and After Decompressive Spinal Surgery: Preliminary Results.
abstract: OBJECTIVE
  Diffusion tensor imaging (DTI) metrics of the cervical spinal cord in patients with cervical spondylotic myelopathy (CSM) were compared to those measured in healthy volunteers, using tract-specific region of interests (ROIs) across all cervical intervertebral disc levels.
  
  
  METHODS
  Magnetic resonance (MR) imaging of the cervical spinal cord was performed in four patients with CSM and in five healthy volunteers on a 3-T MR scanner. Region-specific fractional anisotropy (FA) and mean diffusivity (MD) were calculated on axial imaging with ROI placement in the anterior, lateral, and posterior regions of the spinal cord. FA and MD were also calculated on sagittal acquisitions. Nonparametric statistical tests were used to compare controls and patients before and after surgery.
  
  
  RESULTS
  FA values were significantly lower (p = 0.050) and MD values were significantly higher (p = 0.014) in CSM patients measured at level of maximal compression before surgery than in healthy controls in lateral and posterior ROIs, respectively. In posterior ROIs, MD values were significantly higher in patients before surgery compared to controls at all levels except C7-T1.
  
  
  CONCLUSIONS
  Patients with CSM may demonstrate region-specific changes in DTI metrics when compared to healthy controls. Changes in DTI metrics may also occur at levels remote from site of compression.
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: K Y
authors.initials: KY
authors.lastname: Wang
authors.affiliation: Division of Neuroradiology, Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 North Wolfe Street, 21287, Phipps B-126-B, Baltimore, MD, USA.
authors.forename: O
authors.initials: O
authors.lastname: Idowu
authors.affiliation: Johns Hopkins Biostatistics Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: C B
authors.initials: CB
authors.lastname: Thompson
authors.affiliation: Division of Neuroradiology, Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 North Wolfe Street, 21287, Phipps B-126-B, Baltimore, MD, USA.
authors.forename: G
authors.initials: G
authors.lastname: Orman
authors.affiliation: Diagnostic Imaging at Anne Arundel Medical Center, Annapolis, MD, USA.
authors.forename: C
authors.initials: C
authors.lastname: Myers
authors.affiliation: Department of Orthopedic Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: L H
authors.initials: LH
authors.lastname: Riley
authors.affiliation: Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Carrino
authors.affiliation: Siemens Corporate Research, Center for Applied Medical Imaging, Orange, CA, USA.
authors.forename: A
authors.initials: A
authors.lastname: Flammang
authors.affiliation: Siemens Corporate Research, Imaging and Visualization, Baltimore, MD, USA.
authors.forename: W
authors.initials: W
authors.lastname: Gilson
authors.affiliation: Kennedy Krieger Institute, International Center for Spinal Cord Injury, Baltimore, MD, USA.
authors.forename: C L
authors.initials: CL
authors.lastname: Sadowsky
authors.affiliation: Division of Neuroradiology, Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 North Wolfe Street, 21287, Phipps B-126-B, Baltimore, MD, USA. iizbuda1@jhmi.edu.
authors.forename: I
authors.initials: I
authors.lastname: Izbudak
mesh_terms: D000368:Aged; D019299:Decompression, Surgical / Q000379:methods*; D056324:Diffusion Tensor Imaging / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D010865:Pilot Projects; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging* / Q000209:etiology / Q000517:prevention & control*; D055009:Spondylosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D016896:Treatment Outcome
keywords: Cervical spondylotic myelopathy; Diffusion tensor imaging; Magnetic resonance imaging; Spinal cord