Diagnostic Value of Diffusion Tensor Imaging Indices in Assessment of Cervical Spondylotic Myelopathy

Gamal Madi Mohamed, Sara; Ahmed Mohamed Abdel-gawad, Enas; Darwish, Mohab Mohamed Nageeb; Mahmoud Ragaa Mohamed, Sara

doi:10.21608/mjmr.2023.216038.1416

Diagnostic Value of Diffusion Tensor Imaging Indices in Assessment of Cervical Spondylotic Myelopathy

Document Type : Original Article

Authors

¹ Diagnostic Radiology, Faculty of medicine, Minia University

² Diagnostic Radiology, Faculty of Medicine- Minia University

³ neurosurgery unit , department of surgery , Faculty of Medicine , Minia university , Minia , Egypt

⁴ Diagnostic Radiology Faculty of Medicine Minia University

10.21608/mjmr.2023.216038.1416

Abstract

Background: Cervical spondylotic myelopathy (CSM) develops progressively resulting from spinal cord's long-term segmental compression and it is identified by degenerative alterations to the vertebrae, intervertebral discs, facets, and related ligaments. Imaging is the most important modality to confirm the diagnosis of CSM and Magnetic resonance imaging (MRI) has become the preferred screening method for evaluation of cervical spine myelopathy. Now there is a direction to use advanced MRI techniques for more confirmation of diagnosis and better image quality, Diffusion tensor imaging (DTI) now become the most important advanced technique and diffusion properties can be assessed using the quantitative indices, apparent diffusion coefficient (ADC) and fractional anisotropy (FA), FA and ADC are the most important metrics in assessing the CSM because they are more sensitive and specific than the conventional MRI. Method: This study enrolled 30 patients with cervical spondylotic myelopathy who was diagnosed based on mJOA grading system then MRI was conducted and DTI quantitative and qualitative maps were obtained. Results: We observed a significant difference between FA & ADC metrics at stenotic and non stenotic segments and higher sensitivity and specificity of FA and ADC in diagnosing CSM over the conventional T2 hyper intense signal. Conclusion: DTI metrics are a very effective tool for quantitative evaluation of degenerative CSM.

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