Article Review 2

Author’s Name
Chuan Zhang, Sushant K Das, Dong-Jun Yang, Han-Feng Yang

Article Title
Application of magnetic resonance imaging in cervical spondylotic myelopathy (2014)

Journal Name
Advances in Orthopedics

1) Bibliography
Zhang, C. (2014). Application of magnetic resonance imaging in cervical spondylotic myelopathy. World Journal of Radiology, 6(10), 826. doi:10.4329/wjr.v6.i10.826

2) Purpose of the Article
The purpose of this article was to investigate the application of MR technology to the management of CSM patients and discusses recent and future advances in both conventional and novel MR techniques.

3) Brief Description of Procedure and Findings/Results
This article summarizes that:
i) Conventional MRI provides excellent anatomical information about the spinal cord macrostructure and gives insight into structural histopathological changes in CSM patients.

ii) Diffusion tensor imaging (DTI) is a noninvasive MRI technique that measures the random motion of water molecules and provides information about the cellular integrity and pathology of anisotropic tissues. DTI can provide unique quantitative information on the microstructural features of white matter in the central nervous system. The significance of ADC and FA measurements of DTI is more sensitive and specific than conventional MRI and can detect damage of the white matter tracts before a high signal lesion appears on T2 imaging.

iii) Magnetic resonance spectroscopy (MRS) application to CSM has more advantages compared with DTI. MRS can provide metabolic information about the cellular biochemistry and function of the neural structures within the cervical spinal cord. MRS also can be used to assay a series of a pertinent biochemical marker. Although less studied, cervical spine MRS has recently been used in CSM.

iv) Functional MRI (fMRI) is a functional neuroimaging procedure using MRI technology that measures brain activity by detecting associated changes in blood flow. This technique relies on the coupling of cerebral blood flow and activation of neurons. When an area of the brain is active, the flow of blood in the region also increases. The current clinical application of fMRI is relatively small. Some researchers consider that spinal fMRI can reveal spinal cord function below the site of injury and may provide objective information that can be used for assessing retained function, designing rehabilitation programs, predicting the potential for recovery of function in spinal cord injury, and for assessing new experimental treatment strategies.

An increasing number of studies has suggested that DTI and MRS play a significant role in the management of CSM patients, not only to predict outcome following surgical intervention, but they also have several other potential future applications. They also serve as noninvasive methods to monitor asymptomatic or mildly affected patients treated non-operatively for impending neurological. In addition, fMRI plays an important role in assessing neurological functional recovery after decompressive surgery for CSM.

4) Conclusions and Comments
The article concludes that the MR techniques play an indispensable role in the management of CSM patients and have evolved primarily from a diagnostic modality to a method that can potentially predict patient outcome following surgical intervention.

5) The opinion of the Article
I thought this article was easy to understand. It gave me a better understanding of these advanced MR techniques that play an expanded role in the management of CSM patients in the future