Evaluation of DTI Parameter Ratios and Diffusion Tensor Tractography Grading in the Diagnosis and Prognosis Prediction of Cervical Spondylotic Myelopathy
机构：[1]Orthopedics Department, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China[2]Orthopedics Department, The First Affiliated Hospital of Kunming Medical University, Kunming, China外科科室骨科昆明医科大学附属第一医院[3]Orthopedics Department, Changhai Hospital Affiliated to Second Military Medical University, Shanghai, China[4]Radiology Department, Changhai Hospital Affiliated to Second Military Medical University, Shanghai, China
Study Design. Prospective cohort. Objective. To explore the correlations between diffusion tensor imaging (DTI) ratios and diffusion tensor tractography (DTT) grading with clinical symptoms and outcomes of cervical spondylotic myelopathy (CSM). Summary of Background Data. In addition to magnetic resonance imaging (MRI) and computed tomography, DTI may be useful in understanding pathophysiology of spinal cord in earlier stages of the CSM but it may be confounded by age and cervical level, and previous studies had small sample sizes. Methods. Controls (n = 36) and patients with CSM (n = 93) underwent magnetic resonance imaging (MRI) and DTI at the Changhai Hospital of Shanghai between September 2011 and March 2013. Apparent diffusion coefficient (ADC), fractional anisotropy (FA) of white matter (WM), and central grey matter GM) were assessed. Patients were divided into three MRI grades: no abnormal signals; increased T2WI; and increased T2WI and low T1WI. DTT images were divided into three grades: no abnormal signals; abnormal local signal cord and disordered fiber tracts; and distortion of the spinal cord and interrupted fiber tracts. Results. FA and ADC both correlated with age in all three bilateral WM funiculi and GM, whereas FA and ADC ratios only showed correlation with age in the ventral funiculus (VF) and central GM. Differences were observed in ADC ratios and FA ratios from different Japanese Orthopedic Association (JOA) score subgroups and JOA recovery subgroups. For the three WM funiculi and GM, correlations between DTI ratios, JOA scores, and JOA recovery rates were consistently higher than those between DTI values, JOA scores, and JOA recovery rates (all P < 0.05). MRI grading was correlated with the JOA scores (r = -0.674, P < 0.001) but not JOA recovery rates (r = -0.197, P = 0.058), whereas DTT grading was correlated with both JOA scores (r = -0.813, P < 0.001) and JOA recovery rate (r = -0.429, P < 0.001). Conclusion. DTI parameter ratios seemed to be less influenced by age than raw DTI results and could be more valuable than absolute DTI parameters for the evaluation of CSM. DTT grading is more valuable than MRI grading for diagnosis and prognostic prediction in CSM patients.
基金：
"1255 Project'' of Changhai Hospital Affiliated to Second Military Medical University [CH12550900]
第一作者机构：[1]Orthopedics Department, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
共同第一作者：
通讯作者：
通讯机构：[*1]Radiology Department, Changhai Hospital, Second Military Medical University, Shanghai 200433, China[*2]Orthopedics Department, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
推荐引用方式(GB/T 7714)：
Wang Kun,Chen Zhi,Zhang Fan,et al.Evaluation of DTI Parameter Ratios and Diffusion Tensor Tractography Grading in the Diagnosis and Prognosis Prediction of Cervical Spondylotic Myelopathy[J].SPINE.2017,42(4):E202-E210.doi:10.1097/BRS.0000000000001784.
APA：
Wang, Kun,Chen, Zhi,Zhang, Fan,Song, Qingxin,Hou, Canglong...&Shen, Hongxing.(2017).Evaluation of DTI Parameter Ratios and Diffusion Tensor Tractography Grading in the Diagnosis and Prognosis Prediction of Cervical Spondylotic Myelopathy.SPINE,42,(4)
MLA：
Wang, Kun,et al."Evaluation of DTI Parameter Ratios and Diffusion Tensor Tractography Grading in the Diagnosis and Prognosis Prediction of Cervical Spondylotic Myelopathy".SPINE 42..4(2017):E202-E210
