Abstract
BackgroundTo explore the feasibility of the metrics of diffusion kurtosis imaging (DKI) for investigations of the microstructural changes of spinal cord injury in patients with degenerative cervical myelopathy (DCM) and the correlation between Japan Orthopaedic Association (JOA) scores and DKI metrics.MethodsFifty-seven patients with DCM and 38 healthy volunteers underwent 3.0 T magnetic resonance (MR) imaging with routine MRI sequences and DKI from echo-planar imaging sequence. Based on the JOA score, DCM patients were divided into four subgroups. DKI metrics of the DCM group and control group were obtained and compared, separately for the white matter (WM) and the gray matter (GM).ResultsThe FA values in WM were significantly lower (P = 0.020) in the DCM group than in the control group. The MK values in GM were lower (P = 0.011) in the DCM group than in the control group. The MD values in WM were significantly higher (P = 0.010) in the DCM group than in the control group. In GM, the JOA score was positively correlated with the MK values (r = 0.768, P < 0.05). In the WM, the JOA score was positively correlated with the FA values (r = 0.612, P < 0.05).ConclusionDKI provides quantitive evaluation to the characters of microstructure of the spinal cord damage in patients with DCM compared to conventional MR. MK values can reflect microstructural abnormalities of gray matter of the cervical spinal cord and provide more information beyond that obtained with routine diffusion metrics. In addition, MK values of GM and FA values of WM may as a be highly sensitive biomarker for the degree of cervical spinal cord damage.
Highlights
To explore the feasibility of the metrics of diffusion kurtosis imaging (DKI) for investigations of the microstructural changes of spinal cord injury in patients with degenerative cervical myelopathy (DCM) and the correlation between Japan Orthopaedic Association (JOA) scores and DKI metrics
In gray matter (GM), the JOA score was positively correlated with the mean kurtosis (MK) values(r = 0.768, P = 0.018)
We found that fractional anisotropy (FA) values of normal-appearing white matter (WM) were significantly lower (P = 0.002) in DCM patients than in healthy controls, which is consistent with Li et al [20]
Summary
To explore the feasibility of the metrics of diffusion kurtosis imaging (DKI) for investigations of the microstructural changes of spinal cord injury in patients with degenerative cervical myelopathy (DCM) and the correlation between Japan Orthopaedic Association (JOA) scores and DKI metrics. Degenerative cervical myelopathy (DCM) is a common degenerative disease that causes cervical spinal cord (CSC) dysfunction. In this condition, osteophytes occurs during bone formation, disc degeneration and ligament hypertrophy compress or stimulate the CSC, which subsequently causes sensory and motor dysfunction or even paraplegia [1,2,3]. The absence of abnormal signal changes in the T2-weighted imaging during the early stage of the disease can lead and misdiagnosis or mistreatment [2]. Despite the clinical manifestations of the condition, no abnormal intensity is usually observed in the CSC in the conventional MR imaging during the early clinical stages. A quantitative method for evaluating the microscopic damage of CSC in patients with DCM is highly required
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