Диффузионнотензорная магнитнорезонансная томография при шейной спондилогенной миелопатии

Abstract

Degenerative spondylogenic myelopathy is one of the common causes of spinal cord dysfunction leading to non-traumatic spastic paraparesis and tetraparesis. Despite the fact that conventional magnetic resonance imaging (MRI) is a gold standard for radiologic examination of spinal cord, its application for the assessment of disease prognosis and recovery is limited. Over the past decade, diffusion tensor MRI (DT MRI) based on the ability for selective diffusion of water molecules has gained popularity in the evaluation of patients with cervical spondylogenic myelopathy (CSM). The aim of the review is to collect and analyze the existing studies on the use of DT MRI in CSM, to highlight the main directions that can be applied in clinical practice, to review and deepen into the technical aspects of this method of diagnosis and postoperative control. The literature was selected by key words: diffusion tensor imaging, fractional anisotropy, cervical spondylogenic myelopathy. The review identified areas of greatest diagnostic and prognostic value. The fractional anisotropy (FA) of DTI index had the strongest evidence of utility with evidence of medium quality for its use as a biomarker showing correlation with disability in several clinical pathologies. There were also clear correlations between FA scores and clinical mJOA score. It can be concluded that DTI is an informative method for CSM, opening new possibilities for differential diagnosis and postoperative control, though further studies are needed for standardization and validation of its use before it can be implicated in the clinical practice.