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Accuracy of Diffusion Tensor Imaging for Diagnosing Cervical Spondylotic Myelopathy in Patients Showing Spinal Cord Compression

Authors
 Seungbo Lee  ;  Young Han Lee  ;  Tae-Sub Chung  ;  Eun-Kee Jeong  ;  Sungjun Kim  ;  Yeon Hwa Yoo  ;  In Seong Kim  ;  Choon-Sik Yoon  ;  Jin-Suck Suh  ;  Jung Hyun Park 
Citation
 KOREAN JOURNAL OF RADIOLOGY, Vol.16(6) : 1303-1312, 2015 
Journal Title
 KOREAN JOURNAL OF RADIOLOGY 
ISSN
 1229-6929 
Issue Date
2015
MeSH
Adult ; Aged ; Aged, 80 and over ; Cervical Vertebrae ; Diffusion Tensor Imaging* ; Echo-Planar Imaging ; Female ; Humans ; Male ; Middle Aged ; ROC Curve ; Radiography ; Sensitivity and Specificity ; Severity of Illness Index ; Spinal Cord Compression/diagnosis* ; Spinal Cord Compression/diagnostic imaging ; Spinal Cord Compression/pathology ; Spinal Cord Diseases/diagnosis* ; Spinal Cord Diseases/diagnostic imaging ; Spinal Cord Diseases/pathology
Keywords
Cervical spondylotic myelopathy ; Diffusion tensor imaging ; Fractional anisotropy ; Longitudinal diffusivity ; MRI ; Mean diffusivity ; Radial diffusivity
Abstract
OBJECTIVE: To assess the performance of diffusion tensor imaging (DTI) for the diagnosis of cervical spondylotic myelopathy (CSM) in patients with deformed spinal cord but otherwise unremarkable conventional magnetic resonance imaging (MRI) findings. MATERIALS AND METHODS: A total of 33 patients who underwent MRI of the cervical spine including DTI using two-dimensional single-shot interleaved multi-section inner volume diffusion-weighted echo-planar imaging and whose spinal cords were deformed but showed no signal changes on conventional MRI were the subjects of this study. Mean diffusivity (MD), longitudinal diffusivity (LD), radial diffusivity (RD), and fractional anisotropy (FA) were measured at the most stenotic level. The calculated performance of MD, FA, MD∩FA (considered positive when both the MD and FA results were positive), LD∩FA (considered positive when both the LD and FA results were positive), and RD∩FA (considered positive when both the RD and FA results were positive) in diagnosing CSM were compared with each other based on the estimated cut-off values of MD, LD, RD, and FA from receiver operating characteristic curve analysis with the clinical diagnosis of CSM from medical records as the reference standard. RESULTS: The MD, LD, and RD cut-off values were 1.079 × 10(-3), 1.719 × 10(-3), and 0.749 × 10(-3) mm(2)/sec, respectively, and that of FA was 0.475. Sensitivity, specificity, positive predictive value and negative predictive value were: 100 (4/4), 44.8 (13/29), 20 (4/20), and 100 (13/13) for MD; 100 (4/4), 27.6 (8/29), 16 (4/25), and 100 (8/8) for FA; 100 (4/4), 58.6 (17/29), 25 (4/16), and 100 (17/17) for MD∩FA; 100 (4/4), 68.9 (20/29), 30.8 (4/13), and 100 (20/20) for LD∩FA; and 75 (3/4), 68.9 (20/29), 25 (3/12), and 95.2 (20/21) for RD∩FA in percentage value. Diagnostic performance comparisons revealed significant differences only in specificity between FA and MD∩FA (p = 0.003), FA and LD∩FA (p < 0.001), FA and RD∩FA (p < 0.001), MD and LD∩FA (p = 0.024) and MD and RD∩FA (p = 0.024). CONCLUSION: Fractional anisotropy combined with MD, RD, or LD is expected to be more useful than FA and MD for diagnosing CSM in patients who show deformed spinal cords without signal changes on MRI.
Files in This Item:
T201506078.pdf Download
DOI
10.3348/kjr.2015.16.6.1303
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sungjun(김성준) ORCID logo https://orcid.org/0000-0002-7876-7901
Park, Jung Hyun(박중현) ORCID logo https://orcid.org/0000-0003-3262-7476
Suh, Jin Suck(서진석) ORCID logo https://orcid.org/0000-0001-9455-9240
Yoon, Choon Sik(윤춘식) ORCID logo https://orcid.org/0000-0003-2010-6710
Lee, Young Han(이영한) ORCID logo https://orcid.org/0000-0002-5602-391X
Chung, Tae Sub(정태섭)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/157230
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