Comparison and Clinical Utility of Pre- and Postoperative Diffusion Tensor Imaging MRI Findings in Patients with Cervical Spondylotic Myelopathy

Öz

Aim: This study aimed to present the cervical diffusion tensor imaging (DTI) results in cervical spondylotic myelopathy (CSM) patients scheduled for operation and follow-up. Material and Method: This clinical cohort type study was conducted between January 2016 and May 2016 in the neurosurgery clinic of a tertiary hospital. The study included 27 patients diagnosed with cervical spondylotic myelopathy. Surgical treatment was recommended to 15 patients and follow-up to the remaining. Cervical magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) scans were performed, and anteroposterior canal diameters, apparent diffusion coefficient (ADC), and fractional anisotropy (FA) values were calculated. Results: The mean age was 62.37±7.39, and 22.2% (n=6) were women. Hoffmann pathological reflex was detected in 11 (40.7%) patients. The preoperative and postoperative AP (4.18±0.85 vs. 6.66±1.00, p<0.001), ADC (1.49±0.16 vs. 1.30±0.11, p=0.001), and FA (0.36±0.04 vs. 0.43±0.04, p=0.001) values were significantly different. The FA values of patients scheduled for follow-up were significantly higher than those who were recommended surgery (0.43±0.04 vs. 0.37±0.04, p=0.001). A negative correlation was found between FA and ADC values in both preoperative (r=-0.618, p<0.001) and postoperative (r=-0.748, p=0.013) measurements. Conclusion: DTI is a radiological tool that can aid in diagnosing CSM and identifying patients requiring surgery or follow-up. Due to its expected clinical benefits, we recommend a more widespread application of this method in patients with CSM.

Anahtar Kelimeler

• Diffusion tensor imaging
• spinal cord diseases
• myelopathy
• surgery

Kaynakça

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