| Objective Through the diffusion tensor imaging and diffusion tensor tracking research in normal cervical spinal cord, cervical spondylosis, intramedullary and Extramedullary tumor of cervical spinal cord, discussing the clinical value of the MR-DTI in cervical spinal cord.Method 47 healthy volunteers were introduced in this study as control group A,32 cases of the Cervical spondylosis patient whose cord being compressed with or without abnormal T2 signal in cervical spinal cord were included into Group B,10 cases of the patient who intramedullary spinal cord tumor as Group C,8 cases of the patient whose Cervical thoracic extramedullary tumor as Group D, All of them were imaged using T1-weighted, T2-weighted, and diffusion tensor imaging (DTI) sequences, and rebuilding with diffusion tensor tracking(DTT), by using GE EXCITEⅡ3.0T MR system. For DTI, we used axial single shot echo-planar imaging sequences, b value 0,800 s/mm2,20 directions. All of the DTI data was analyzed by with GE functool 3.0 software, The values of ADC, FA,λ1,λ2 andλ3 were measured at C2-3,C4-5 or the lesion area and C6-7 levels of the cervical spinal cord according to the b=0 map in all the groups. The Parameters of DTI were analyzed with ANOVA or t-test, by software package SPSS 17.0, was compared at the lever of the ADC, FA,λ1,λ2,λ3 value. Then rebuilding Diffusion tensor tracking imaging, compared With conventional MRI imaging and surgical results, two experienced radiologists analyzed the morphological characteristics of fibers each group With a double-blind method, the diagnosis value of rebuilding the imaging of the DTT fiber bundle in spinal cord was studied.Result In group A (healthy volunteers), The average values of FA in lever C2-3, C4-5, C6-7 were 0.708±0.066,0.635±0.070,0.549±0.065; ADC were 10.37±1.61,10.87±2.06,12.57±1.99(Units:10-10m2/s);λ1 were 5.47±0.28,5.48±0.29,5.47±0.28;λ2 were 3.98±0.16,4.13±0.18, 4.29±0.21;λ3 were 4.13±0.18,4.24±0.25,4.37±0.19(Units:10-9m2/s); There were significant changes in FA(F=65.313, P=0.000), ADC(F=17.273, P=0.000),λ2(F=34.029, P=0.000),λ3(F=14.878, P=0.000) between the levels of C2-3,C4-5 and C6-7. By the two-two comparisons, among ADC value, there were no significant differences in data between the level C2-3 and C4-5, and there were significantly differences between level C6-7 and level C2-3, C4-5. The other Parameters such as FA value,λ2,λ3, there were significantly differences between each level.Compare ADC, FA,λ1,λ2,λ3 value between group A(healthy volunteers) and group B(Cervical spondylosis), There were no significant changes in each parameter except ADC (t=3.013, P=0.004) of lever C2-3, but significant changes in ADC, FA,λ2,λ3 value exceptλ1 in lever C4-5 or lesion eara, significant changes in each parameter of lever C6-7.Compare group group B(Cervical spondylosis), C(intramedullary tumor) and D(extramedullary tumor) in the same lever, There were significant changes in FA(F=8.507, P=0.001), ADC(F=4.640, P=0.016),λ2(F=7.661, P=0.002),λ3(F=7.773, P=0.002) of lever C2-3 or above lesion area; There were significant changes in FA(F=7.732, P=0.002),λ1(F=7.208, P=0.002) of lesion area; It also have significant changes in FA (F=6.663, P=0.003).Through the two-two comparisons, C group was significant difference with B, D group in FA, ADC,λ2,λ3 of above lesion area(or C2-3), C group was significant different with B, D group in FA; D group was also significant different with B, C group inλ1 of lesion area; D group was also significant different with B, C group in FA of the below lesion area(or C6-7). There were no significant changes in other DTI parameter.As the surgical results to be standard, the positioning diagnostic in DTT was more accuracy than conventional MRI, spinal cord fiber bundle was under pressure or broken at the compression level clearing in DTT rebuilding imaging, Consistent with the surgical results.Conclusion(1) SE-EPI Sequence can be non-invasive successfully used in Cervical Spinal Cord, and can be quantitative analysised Water molecules diffusion in the spinal cord disease.(2) DTI imaging showed spinal cord injury in cervical spondylosis better than conventional MRI.(3) In spinal cord disease, FA, ADC,λ1,λ2,λ3 value all Varying changed in spinal cord lesion area and its above, below area, in which the FA,λ2,λ3 value is more sensitive and stable.(4) Diffusion Tensor Tracking can display changes of anatomical structure of cervical spinal cord and fibers on the spinal cord white matter, it is helpful in diagnosis of the lesion in spinal cord, and can provide guidance in surgical resection. |
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