Preliminary Study Of Diffusion Tensor Imaging (DTI) In Early Cervical Spondylotic Myelopathy

Chapter 1 Quantitatively analysis of DTI of the cervical spinal cordObjectiveTo explore the clinical application value of diffusion tensor imaging(DTI),by studying normal diffusion tensor imaging of the cervical spinal cord in healthy volunteers.MethodsCervical spinal cord routine MRI and DTI are performed in 30 cases of healthy volunteers.Conventional cervical MRI scan using spin echo sequence,respectively,sagittal T1WI,sagittal T2WI,axial T2WI,axial T2WIC2/3-C6/7 of each disc scan.Sagittal DTI imaging using single-shot spin echo plane imaging technology,imaging range from the medulla oblongata to the 1st thoracic vertebral level,sagittal DTI examination and conventional scanning positioning the same,diffusion weighted coefficient(b)is 0 and 500,respectively,Diffusion-sensitive gradient are taken in 15 different directions.Import DTI’s raw data into GE functool software for post-processing.ADC layer and FA layer are obtained for each level after processing.Then use DTI and T2WI sagittal image fusion assisted positioning.The region of interest is placed on the image with b = 0.The ROI is measured at the anterior cervical spinal cord corresponding to each cervical intervertebral disc.FA and ADC values are measured and the ROI is kept as uniform as possible.Measure to avoid cerebrospinal fluid.The radiological findings are analyzed,and the fractional anisotropy(FA)values and the apparent diffusion coefficient(ADC)values are calculated,and the diffusion tensor tracking(DTT)images are reconstructed.ResultsThe FA and ADC images of cervical spinal cord of all subjects are obtained.The FA values of cervical segments of C2/3-C6/7 are 0.779 ± 0.034,0.732 ± 0.041,0.699 ±0.038,0.656±0.042,0.598±0.68 respectively.The ADC values of different segments are 0.975±0.068,0.993±0.087,1.012±0.086,1.105±0.144 and 1.238± 0.199,respectively.The FA values of different segments of cervical spinal cord(F = 43.096,P = 0.000).The FA values and ADC values are significant difference among different segments of cervical spinal cord(P<0.05).C2/3 segment is the highest FA value,the lowest ADC value;C6/7 segment is the lowest FA value and the highest ADC value.It’s a negative correlation between the FA values and the ADC values..Conclusion(1)DTI imaging technique can quantitatively evaluate the dispersion of water molecules in the cervical spinal cord without damage;(2)FA values and ADC values were different in different segments of normal rats FA values decreased gradually from C2/3 to C6/7 segments;ADC values gradually increased from C2/3 to C6/7 segment values;(3)There was a negative correlation between FA value and ADC value.(4)DTI can objectively and quantitatively analyze the cervical spinal cord,there are important clinical application value.Chapter 2 Study on Magnetic Resonance Diffusion Tensor Imaging of Early Cervical Spondylotic MyelopathyObjectiveThrough the study of magnetic resonance diffusion tensor imaging(DTI)of early cervical spinal cord cervical spondylotic myelopathy,the diffusion of water molecules in tissues was quantitatively analyzed.To explore the microstructure and pathophysiological changes of tissue,and to explore the clinical value of DTI in assessing nerve injury in patients with early cervical spondylotic myelopathy.MethodsCervical spinal cord routine MRI and DTI were performed in 25 patients with early diagnosis of cervical spondylotic myelopathy.The radiological findings were analyzed,and the fractional anisotropy(FA)values and the apparent diffusion coefficient(ADC)values were calculated,and the diffusion tensor tracking(DTT)images were reconstructed.ResultsThe FA and ADC images of the cervical spinal cord DTI were obtained from all the subjects.The FA values and ADC values of the C3/4,C4/5,C5/6 segments were significantly different.The FA values of C3/4,C4/5 and C5/6 were 0.618±0.034,0.589±0.034 and 0.558±0.653,respectively,and the ADC values were 1.08±0.078,1.125±0.128,1.442±0.217.There were statistically significant differences in the FA values and ADC values between the three normal segments and the cervical spondylotic myelopathy group(P<0.05).Conclusion(1)DTI imaging technique can quantitatively assess the dispersion of water molecules in the cervical spinal cord and its pathophysiological changes without damage.(2)Patients with cervical spondylotic myelopathy in the spinal cord compression site than the normal FA value decreased,ADC value increased(3)DTI can detect early cervical lesions earlier than conventional MRI and can be used to assess spinal cord compression;(4)DTI has important value in evaluating early cervical myeloid cervical spondylosis.