Diffusion tensor imaging can predict surgical outcomes of patients with cervical compression myelopathy

被引：55

作者：

Maki, Satoshi ^{[1
]}

Koda, Masao ^{[1
]}

Kitamura, Mitsuhiro ^{[1
]}

Inada, Taigo ^{[1
]}

Kamiya, Koshiro ^{[1
]}

Ota, Mitsutoshi ^{[1
]}

Iijima, Yasushi ^{[1
]}

Saito, Junya ^{[1
]}

Masuda, Yoshitada ^{[2
]}

Matsumoto, Koji ^{[2
]}

Kojima, Masatoshi ^{[2
]}

Obata, Takayuki ^{[3
]}

Takahashi, Kazuhisa ^{[1
]}

Yamazaki, Masashi ^{[4
]}

Furuya, Takeo ^{[1
]}

机构：

[1] Chiba Univ, Dept Orthopaed Surg, Grad Sch Med, Chuou Ku, 1-8-1 Inohana, Chiba, Chiba 2608670, Japan

[2] Chiba Univ Hosp, Dept Radiol, Chuou Ku, 1-8-1 Inohana, Chiba, Chiba 2600856, Japan

[3] Natl Inst Radiol Sci, Ctr Charged Particle Therapy, Inage Ku, 4-9-1 Anagawa, Chiba, Chiba 2638555, Japan

[4] Univ Tsukuba, Dept Orthopaed Surg, Fac Med, 1-1-1 Tennodai, Tsukuba, Ibaraki 3058577, Japan

来源：

EUROPEAN SPINE JOURNAL | 2017年 / 26卷 / 09期

关键词：

Magnetic resonance imaging; Diffusion tensor imaging; Cervical spondylotic myelopathy; Ossification of the longitudinal ligament; Spinal cord; Surgical outcomes; ORTHOPEDIC ASSOCIATION SCALE; SIGNAL INTENSITY RATIO; SPONDYLOTIC MYELOPATHY; SPINAL-CORD; EXPANSIVE LAMINOPLASTY; PROGNOSTIC-FACTORS; CLINICAL ARTICLE; DISEASE SEVERITY; SURGERY; TRACTOGRAPHY;

D O I：

10.1007/s00586-017-5191-7

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

100204 [神经病学];

摘要：

The aim of this study was to assess the potential role of diffusion tensor imaging (DTI) as a predictor of surgical outcomes in patients with cervical compressive myelopathy (CCM). Surgical decompression is often recommended for symptomatic CCM. It is important to know the prognosis of surgical outcomes and to recommend appropriate timing for surgery. We enrolled 26 patients with CCM who underwent surgery. The Japanese Orthopaedic Association (JOA) score for cervical myelopathy was evaluated before and 6 months after surgery. Surgical outcomes were regarded as good if there was a change in JOA score of three points or more, or the recovery rate of JOA score was 50% or more. The patients were examined using a 3.0 T magnetic resonance system before surgery. Measured diffusion parameters were fractional anisotropy (FA) and mean diffusivity (MD). The correlations between DTI parameters and surgical outcomes were analyzed. Both change and recovery rate of JOA score moderately correlated with FA. Furthermore, the area under the receiver-operator characteristic curve based on FA for prognostic precision of surgical outcomes indicates that FA is a good predictive factor. The cut-off values of FA for predicting good surgical outcomes evaluated by change and recovery rate of JOA score were 0.65 and 0.57, respectively. Neither change nor recovery rate of JOA score correlated with MD. FA in spinal cord DTI can moderately predict surgical outcomes. DTI can serve as a supplementary tool for decision-making to guide surgical intervention in patients with CCM.

引用

页码：2459 / 2466

页数：8

共 42 条

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