Abstract
Age-related degeneration of the cervical spinal column is the most common cause of spinal cord lesions. T1 mapping has been shown to indicate the grade and site of spinal cord compression in low grade spinal canal stenosis (SCS). Aim of our study was to further investigate the diagnostic potential of a novel T1 mapping method at 0.75 mm resolution and 4 s acquisition time in 31 patients with various grades of degenerative cervical SCS. T1 mapping was performed in axial sections of the stenosis as well as above and below. Included subjects received standard T2-weighted MRI of the cervical spine (including SCS-grading 0-III), electrophysiological, and clinical examination. We found that patients with cervical SCS showed a significant difference in T1 relaxation times within the stenosis (727 ± 66 ms, mean ± standard deviation) in comparison to non-stenotic segments above (854 ± 104 ms, p < 0.001) and below (893 ± 137 ms, p < 0.001). There was no difference in mean T1 in non-stenotic segments in patients (p = 0.232) or between segments in controls (p = 0.272). Mean difference of the T1 relaxation times was significantly higher in grade III stenosis (234 ± 45) vs. in grade II stenosis (176 ± 45, p = 0.037) vs. in grade I stenosis (90 ± 87 ms, p = 0.010). A higher difference in T1 relaxation time was associated with a central efferent conduction deficit. In conclusion, T1 mapping may be useful as a tool for SCS quantification in all grades of SCS, including high-grade stenosis with myelopathy signal in conventional T2-weighted imaging.
Highlights
Narrowing of the cervical spinal canal is a frequent finding in neuroimaging of the elderly
Degenerative changes, mostly causing spinal canal stenosis, affect up to 90% of the population over the age of 60 years [1]. They can lead to significant clinical morbidity by causing cervical spinal canal stenosis (SCS) and, in greater extent, spinal cord compression
The aim of the present study was to further evaluate the potential of quantitative T1 mapping in the diagnosis of cervical SCS, by including patients with severe SCS and prolonged spinal cord compression as well as by using a 1.5 T magnetic resonance imaging (MRI) system, which is frequently used in the routine diagnostic workup of SCS
Summary
Narrowing of the cervical spinal canal is a frequent finding in neuroimaging of the elderly. Degenerative changes, mostly causing spinal canal stenosis, affect up to 90% of the population over the age of 60 years [1]. They can lead to significant clinical morbidity by causing cervical spinal canal stenosis (SCS) and, in greater extent, spinal cord compression. The variability in the clinical presentation in patients with SCS often makes it difficult to establish the diagnosis early. Early treatment is essential to keep track of the course of the disease and to prevent persistent deterioration [2]. Further pitfalls in the diagnosis and therapy of SCS are inconsistent recommendations concerning conservative or surgical treatment [including its ideal timepoint [3]] and the diagnostic procedures this decision should be based on [4, 5]
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