Reduced Field-of-View Diffusion Tensor Imaging of the Spinal Cord Shows Motor Dysfunction of the Lower Extremities in Patients With Cervical Compression Myelopathy.
METHODS
A cross-sectional study.


OBJECTIVE
The aim of this study was to quantify spinal cord dysfunction at the tract level in patients with cervical compressive myelopathy (CCM) using reduced field-of-view (rFOV) diffusion tensor imaging (DTI).


BACKGROUND
Although magnetic resonance imaging (MRI) is the standard used for radiological evaluation of CCM, information acquired by MRI does not necessarily reflect the severity of spinal cord disorder. There is a growing interest in developing imaging methods to quantify spinal cord dysfunction. To acquire high-resolution DTI, a new scheme using rFOV has been proposed.


METHODS
We enrolled 10 healthy volunteers and 20 patients with CCM in this study. The participants were studied using a 3.0-T MRI system. For DTI acquisitions, diffusion-weighted spin-echo rFOV single-shot echo-planar imaging was used. Regions-of-interest (ROI) for the lateral column (LC) and posterior column (PC) tracts were determined on the basis of a map of fractional anisotropy (FA) of the spinal cord and FA values were measured. The FA of patients with CCM was compared with that of healthy controls and correlated with Japanese Orthopaedic Association (JOA) score.


RESULTS
In LC and PC tracts, FA values in patients with CCM were significantly lower than in healthy volunteers. Total JOA scores correlated moderately with FA in LC and PC tracts. JOA subscores for motor dysfunction of the lower extremities correlated strongly with FA in LC and PC tracts.


CONCLUSIONS
It is feasible to evaluate the cervical spinal cord at the tract level using rFOV DTI. Although FA values at the maximum compression level were not well correlated with total JOA scores, they were strongly correlated with JOA subscores for motor dysfunction of the lower extremities. Our findings suggest that FA reflects white matter dysfunction below the maximum compression level and FA can be used as an imaging biomarker of spinal cord dysfunction.


METHODS
4.
Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
Satoshi
S
Maki
Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
Masao
M
Koda
Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
Mitsutoshi
M
Ota
Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
Yoshihiro
Y
Oikawa
Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
Koshiro
K
Kamiya
Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
Taigo
T
Inada
Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
Takeo
T
Furuya
Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
Kazuhisa
K
Takahashi
Department of Radiology, Chiba University Hospital, Chiba, Japan.
Yoshitada
Y
Masuda
Department of Radiology, Chiba University Hospital, Chiba, Japan.
Koji
K
Matsumoto
Department of Radiology, Chiba University Hospital, Chiba, Japan.
Masatoshi
M
Kojima
Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba.
Takayuki
T
Obata
Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Masashi
M
Yamazaki
D000328:Adult; D000368:Aged; D016880:Anisotropy; D003430:Cross-Sectional Studies; D004058:Diffusion; D056324:Diffusion Tensor Imaging / Q000379:methods; D017352:Echo-Planar Imaging; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013116:Spinal Cord / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging* / Q000503:physiopathology