Akihiko Wada MD, Presenter: Nothing to Disclose

Masahiko Matsusaki, Abstract Co-Author: Nothing to Disclose

Shiro Ozaki, Abstract Co-Author: Nothing to Disclose

Shinji Hara, Abstract Co-Author: Nothing to Disclose

Akihiko Matsumura, Abstract Co-Author: Nothing to Disclose

Nobuhiro Yada, Abstract Co-Author: Nothing to Disclose

Takashi Katsube, Abstract Co-Author: Nothing to Disclose

Masakatsu Tsurusaki MD, PhD, Abstract Co-Author: Nothing to Disclose

Kazutoshi Kamiyama, Abstract Co-Author: Nothing to Disclose

Nobuko Yamamoto MD, Abstract Co-Author: Nothing to Disclose

Koji Uchida, Abstract Co-Author: Nothing to Disclose

Takeshi Yoshizako MD, Abstract Co-Author: Nothing to Disclose

Hajime Kitagaki MD, Abstract Co-Author: Nothing to Disclose

In cervical compression myelopathy, intramedullary T2 high signal intensity indicates a presence of myelopathy lesion, but the degree of T2 high signal intensity is not always equal to symptomatic severity and its postoperative change is various and is not enough for evaluation of therapeutic effect. In this study, we investigated the utility and potentiality of diffusion tensor analysis in evaluation of the therapeutic effect of cervical decompression surgery.

Diffusion tensor imaging (DTI) was performed in seven cervical myelopathy subjects at before and after decompression surgery. Results of diffusion tensor analysis were compared with a change of JOA score (Japanese Orthopedic Association scoring system for evaluation of cervical compression myelopathy) which was a clinical evaluation criteria of severity of cervical myelopathy (full point: 17 points). All DTI was performed on 3.0 T MR unit (Signa 3.0 HDx, GE healthcare, USA) with echo planar sequence; transaxial plane, TR/TE: 17000/89.2, FOV: 16ｘ16cm, matrix: 256 x 256, slice thickness: 3mm, MPG: b=0,700 (6 directions),NEX: 6, acquisition time: 12min11sec. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) value was measured at C2-7 vertebral body levels and C2/3 - C7/Th1 intervertebral levels.

The mean value of preoperative JOA score was 10.8 (6 - 15.5) and postoperative improvement was present in all cases (0.5-6 points increased).On postoperative study, intramedullary T2 high signal intensity showed various changes (reduction: 1, no change: 2, enlargement: 4) and did not relate to therapeutic effect. In all cases, abnormality of ADC/ FA at T2 high signal intensity lesion (mean: 1.09/0.49) improved after surgery (mean: 0.95/0.54). The abnormality of ADC and FA progressed beyond T2 high signal intensity area and these extra abnormalities were also improved after surgery. The postoperative change of ADC was often varied and not always equal to FA. In one case, increase of ADC was recognized.  

DTI becomes a new evaluation method for seriousness and therapeutic effect of cervical myelopathy. It is considered that ADC and FA are independent evaluation factors.

DTI can detect the spinal tissue injury that T2-weighted image cannot reveal. ADC/FA can become an independent index of evaluation of a seriousness of myelopathy and a therapeutic effect of deco

Wada, A, Matsusaki, M, Ozaki, S, Hara, S, Matsumura, A, Yada, N, Katsube, T, Tsurusaki, M, Kamiyama, K, Yamamoto, N, Uchida, K, Yoshizako, T, Kitagaki, H, Evaluation of the Therapeutic Effect of Cervical Decompression Surgery by Using Diffusion Tensor Analysis.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9005910.html