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Article: Is diffusion anisotropy a biomarker for disease severity and surgical prognosis of cervical spondylotic myelopathy

TitleIs diffusion anisotropy a biomarker for disease severity and surgical prognosis of cervical spondylotic myelopathy
Authors
Issue Date2014
Citation
Radiology, 2014, v. 270, n. 1, p. 197-204 How to Cite?
AbstractPurpose: To explore the value of diffusion-tensor (DT) imaging in addressing the severity of cervical spondylotic myelopathy (CSM) and predicting the outcome of surgical treatment. Materials and Methods: From July 2009 to May 2012, 65 volunteers were recruited for this institutional review board-approved study, and all gave informed consent; 20 volunteers were healthy subjects (age range, 41-62 years), and 45 were patients with CSM (age range, 43-86 years). Anatomic and DT 3.0-T magnetic resonance images were obtained. Surgical decompression was performed in 22 patients with CSM, and patients were followed up for 6 months to 2 years. The clinical severity of myelopathy and postoperative recovery were assessed by using the modified Japanese Orthopaedic Association (mJOA) score. A recovery ratio (comparison of postoperative with preoperative mJOA score) of more than 50% indicated a good clinical outcome of surgery. DT findings, patient age, T2 high signal intensity (HSI), and somatosensory evoked potential (SEP) were analyzed by using a logistic regression model to predict the surgical outcome of patients with CSM. Results: A significant difference in cervical cord mean fractional anisotropy (FA) was found between healthy subjects and patients with CSM (0.65 ± 0.05 [standard deviation] vs 0.52 ± 0.13, P < .001). FA values were significantly correlated with the severity of neurologic dysfunction indicated by mJOA score (r2 = 0.327, P = .016). Logistic regression analysis showed that mean FA (P = .030) and FA at the C2 vertebra (P = .035) enabled prediction of good surgical outcome; however, preoperative mJOA (P = .927), T2 HSI (P = .176), SEP amplitude (P = .154), and latency (P = .260) did not. Conclusion: FA is a biomarker for the severity of myelopathy and for subsequent surgical outcome. © RSNA, 2013.
Persistent Identifierhttp://hdl.handle.net/10722/205797
ISSN
2015 Impact Factor: 6.798
2015 SCImago Journal Rankings: 3.414
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWen, Chunyi-
dc.contributor.authorCui, Jiaolong-
dc.contributor.authorLiu, Harris S.-
dc.contributor.authorMak, Kincheung-
dc.contributor.authorCheung, Waiyuen-
dc.contributor.authorLuk, Keith D K-
dc.contributor.authorHu, Yong-
dc.date.accessioned2014-10-06T08:02:22Z-
dc.date.available2014-10-06T08:02:22Z-
dc.date.issued2014-
dc.identifier.citationRadiology, 2014, v. 270, n. 1, p. 197-204-
dc.identifier.issn0033-8419-
dc.identifier.urihttp://hdl.handle.net/10722/205797-
dc.description.abstractPurpose: To explore the value of diffusion-tensor (DT) imaging in addressing the severity of cervical spondylotic myelopathy (CSM) and predicting the outcome of surgical treatment. Materials and Methods: From July 2009 to May 2012, 65 volunteers were recruited for this institutional review board-approved study, and all gave informed consent; 20 volunteers were healthy subjects (age range, 41-62 years), and 45 were patients with CSM (age range, 43-86 years). Anatomic and DT 3.0-T magnetic resonance images were obtained. Surgical decompression was performed in 22 patients with CSM, and patients were followed up for 6 months to 2 years. The clinical severity of myelopathy and postoperative recovery were assessed by using the modified Japanese Orthopaedic Association (mJOA) score. A recovery ratio (comparison of postoperative with preoperative mJOA score) of more than 50% indicated a good clinical outcome of surgery. DT findings, patient age, T2 high signal intensity (HSI), and somatosensory evoked potential (SEP) were analyzed by using a logistic regression model to predict the surgical outcome of patients with CSM. Results: A significant difference in cervical cord mean fractional anisotropy (FA) was found between healthy subjects and patients with CSM (0.65 ± 0.05 [standard deviation] vs 0.52 ± 0.13, P < .001). FA values were significantly correlated with the severity of neurologic dysfunction indicated by mJOA score (r2 = 0.327, P = .016). Logistic regression analysis showed that mean FA (P = .030) and FA at the C2 vertebra (P = .035) enabled prediction of good surgical outcome; however, preoperative mJOA (P = .927), T2 HSI (P = .176), SEP amplitude (P = .154), and latency (P = .260) did not. Conclusion: FA is a biomarker for the severity of myelopathy and for subsequent surgical outcome. © RSNA, 2013.-
dc.languageeng-
dc.relation.ispartofRadiology-
dc.titleIs diffusion anisotropy a biomarker for disease severity and surgical prognosis of cervical spondylotic myelopathy-
dc.typeArticle-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1148/radiol.13121885-
dc.identifier.pmid23942607-
dc.identifier.scopuseid_2-s2.0-84891124663-
dc.identifier.hkuros227450-
dc.identifier.volume270-
dc.identifier.issue1-
dc.identifier.spage197-
dc.identifier.epage204-
dc.identifier.eissn1527-1315-
dc.identifier.isiWOS:000329916100024-

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