Role of MRI Diffusion Tensor Imaging in early diagnosis of Cervical Spondylotic Myelopathy (CSM)

Kamel, Omar Farouk; Ismail, Ahmed Mahmoud Mohamed; El-shinnawy, Maha Abdel Meguid; Elwan, Sherine Ibrahim; Elshimy, Ahmed

doi:10.21608/asmj.2023.229870.1154

Role of MRI Diffusion Tensor Imaging in early diagnosis of Cervical Spondylotic Myelopathy (CSM)

Document Type : Original Article

Authors

¹ Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

² Department of Diagnostic Radiology, Mataryia Teaching Hospital, Egyptian ministry of Health and Population, Cairo, Egypt.

10.21608/asmj.2023.229870.1154

Abstract

Background: Cervical spondylotic myelopathy (CSM) represents a common cervical spine degenerative disease and is one of the most common causes of spinal cord functional impairment in older individuals worldwide. Assessing severity of the disease remains a challenge and there is still controversy regarding the most favorable timing for surgical intervention. Routine MRI is the gold standard radiological modality for spinal cord assessment; however, it cannot assess the underlying microstructural deficits of the cord and has a limited application in determining prognosis of the disease.
Ain of the study: to assess the utility of diffusion tensor imaging as an imaging technique in clinically suggested CSM patients by obtaining the microstructural parameters (FA and ADC) in the cervical spinal cord segments.
Results: Our study had 23 females (57.5%) and 17 males (42.5%). Their age ranged from 30 to 72 years with mean age of 47.3 ± 9.79 years.
Our study showed considerable discrepancy in mean FA and ADC values between normal and stenotic segments of cervical spinal cord and revealed reasonable correspondence between European myelopathy score (EMS) and DTI parameters. FA and ADC values showed better results in detecting CSM in patients who were classified as grade 1 according to EMS compared to routine MRI T2WI. DTI is more sensitive in recognition of early myelopathy changes compared to conventional MRI Conclusions: DTI enhances the effectiveness of MRI in the evaluation of CSM at initial stages. Therefore, it helps to decide the optimal timing of surgical decompression prior to the chronic irreversible changes.

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