Bawarjan Schatlo1,2,3, Luca Remonda1, Philipp Gruber4, Javier Fandino2, Veit Rohde3, Ali-Reza Fathi5, Jatta Berberat6. 1. Department of Neuroradiology, Cantonal Hospital Aarau, Tellstraße 25, 5001, Aarau, Switzerland. 2. Department of Neurosurgery, Cantonal Hospital Aarau, Aarau, Switzerland. 3. Department of Neurosurgery, University Medicine Göttingen, Georg-August University, Göttingen, Germany. 4. Department of Neurology, Cantonal Hospital Aarau, Aarau, Switzerland. 5. Department of Neurosurgery, Hirslanden Clinik, Aarau, Switzerland. 6. Department of Neuroradiology, Cantonal Hospital Aarau, Tellstraße 25, 5001, Aarau, Switzerland. jatta.berberat@ksa.ch.
Abstract
PURPOSE: Diffusion tensor imaging (DTI) in flexion-extension may serve as a diagnostic tool to improve the sensitivity for detection of myelopathy. In this study, the feasibility and reproducibility of dynamic DTI in the cervical spinal cord was assessed in healthy volunteers and patients. METHODS: All subjects were examined in maximum neck flexion-extension in a 3T magnetic resonance imaging (MRI) scanner. Range of motion, space available for the spinal cord, fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured and compared between the neck positions. RESULTS: Volunteers showed no variation in ADC and FA. In patients, extension produced higher ADC in the diseased than in the control segments (p = 0.0045). The ADC of the affected segments was higher in extension than in the neutral position (p = 0.0030) or in flexion (p = 0.0002). The FA was significantly lower in extension in patients at both the control level C2/3 (p = 0.0154) and the affected segment (p = 0.0187). CONCLUSIONS: Dynamic DTI of the cervical spine is feasible and ADC increased in the patient group in extension. This finding may open a previously unexplored avenue to attempt an earlier identification of myelopathy.
PURPOSE: Diffusion tensor imaging (DTI) in flexion-extension may serve as a diagnostic tool to improve the sensitivity for detection of myelopathy. In this study, the feasibility and reproducibility of dynamic DTI in the cervical spinal cord was assessed in healthy volunteers and patients. METHODS: All subjects were examined in maximum neck flexion-extension in a 3T magnetic resonance imaging (MRI) scanner. Range of motion, space available for the spinal cord, fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured and compared between the neck positions. RESULTS: Volunteers showed no variation in ADC and FA. In patients, extension produced higher ADC in the diseased than in the control segments (p = 0.0045). The ADC of the affected segments was higher in extension than in the neutral position (p = 0.0030) or in flexion (p = 0.0002). The FA was significantly lower in extension in patients at both the control level C2/3 (p = 0.0154) and the affected segment (p = 0.0187). CONCLUSIONS: Dynamic DTI of the cervical spine is feasible and ADC increased in the patient group in extension. This finding may open a previously unexplored avenue to attempt an earlier identification of myelopathy.
Authors: Tomasz Tykocki; Philip English; David Minks; Arunkumar Krishnakumar; Guy Wynne-Jones Journal: Neuroradiology Date: 2018-09-19 Impact factor: 2.804