A meta-analysis of the role of diffusion tensor imaging in cervical spinal cord compression.

Abstract

At present, the role of diffusion tensor imaging (DTI) remains controversial. This study aimed to confirm the role of DTI by comparing the differences in fractional anisotropy (FA) values between patients with cervical spinal cord compression (CSCC) and healthy individuals. A systematic and comprehensive literature search was conducted using the Web of Science, Embase, PubMed, and Cochrane Library databases to compare the mean FA values of patients with CSCC and healthy controls across all compression levels in the cervical spinal cord. Essential data from the literature, such as demographic information, imaging parameters, and DTI analysis method, were extracted. Fixed- or random-effect models based on I2 heterogeneity were applied to the pooled and subgroup analyses. Ten studies containing 445 patients and 197 healthy volunteers were eligible. The pooled results demonstrated a decrease in mean FA values across all compression levels in the experiment group compared to those in healthy controls (standardized mean difference=-1.54; 95% confidence interval=[-1.95, -1.14]; p<.001). Meta-regression revealed that the scanner field strength and DTI analysis method had a significant effect on heterogeneity. Our results show that FA values in the spinal cord decline in patients with CSCC, thus confirming the crucial role of DTI in CSCC.