Article Review 14

Authors’ names

Li Guan, Xialong Chen, Yong Hai, Xiaodong Ma, Le He, Guangzhi Wang, Chun Yuan, Hua Guo

Article name

High-resolution Diffusion Tensor Imaging in Cervical Myelopathy: A Preliminary Follow-up Study

Journal Name

NMR in Biomedicine, Willey Online Library

Bibliography

Guan, L., Chen, X., Hai, Y., Ma, X., He, L., Wang, G., … Guo, H. (2017). High-resolution diffusion tensor imaging in cervical spondylotic myelopathy: a preliminary follow-up study. NMR in Biomedicine, 30(10), e3769. doi:10.1002/nbm.3769

Purpose of the article

The purpose of this article was to improve measurement that shows the viable changes in spinal cord with the new development of imaging sequences and compare it with the routinely done.

Brief Description of Procedure and Findings/Results

In order to improve measurement accuracy, newly developed, multi‐shot, high‐resolution, diffusion tensor imaging (DTI) method to investigate diffusion metric changes and compare the outcome with T2‐weighted (T2W) images before and after decompressive surgery for cervical spondylotic myelopathy (CSM). T2W imaging, single‐shot DTI and multi‐shot DTI were employed to scan seven patients with CSM before and 3 months after decompressive surgery. High signal intensities were scored using the T2 W images. DTI metrics, including fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD), were quantified and compared pre‐ and post‐surgery. In addition, the relationship between imaging metrics and neurological assessments was examined. The reproducibility of multi‐shot DTI was also assessed in 10 healthy volunteers. Post‐surgery, the mean grade of cervical canal stenosis was reduced from grade 3 to normal after 3 months. Compared with single‐shot DTI, multi‐shot DTI provided better images with lower artifact levels, especially following surgery, as a result of reduced artifacts from metal implants. The new method also showed acceptable reproducibility. Both FA and RD values from the new acquisition showed significant differences post‐surgery (FA, p = 0.026; RD, p = 0.048). These changes were consistent with neurological assessments. In contrast, T2W images did not show significant changes before and after surgery.

Conclusions and Comments

Multi‐shot diffusion imaging showed improved image quality over single‐shot DWI, and presented a superior performance in the diagnosis and recovery monitoring for patients with CSM compared with T2W imaging. DTI metrics can reflect the pathological conditions of spondylotic spinal cord quantitatively and may serve as a sensitive biomarker for potential CSM management.

The opinion of the article

This article is very useful to expand knowledge regarding magnetic resonance imaging which well-known as the most common modality used to facilitate the diagnosis of cervical myelopathy. There are various manipulations of imaging sequences that can be modified to enhance the accuracy of the outcomes. It is important for radiographer to know the basic knowledge about modalities and manage to use critical thinking in modifying the technology in order to save more lives.