Effectiveness of Diffusion Tensor Imaging in Determining Cervical Spondylotic Myelopathy.

Aim: To determine the effectiveness of diffusion tensor imaging (DTI) in diagnosing cervical spondylotic myelopathy (CSM) in patients with no findings detected in conventional magnetic resonance imaging (MRI).

Material And Methods: Fifty-four patients who presented for cervical MRI between January 2016 and June 2016, with symptoms such as neck pain, paresis, and numbness in hands, were included in the study. The patients were split into four groups based on their degrees of spinal stenosis. The obtained data were examined using special software and color-coded fractional anisotropy (FA), and apparent diffusion coefficient (ADC) maps were formed. Through these maps, using regions of interest (ROIs), FA and ADC values were calculated and the contribution of these values to the diagnosis was evaluated statistically.

Results: When all grades of cervical spinal canal stenosis were compared, a statistically significant negative correlation between spinal canal stenosis degree and FA values, and a positive correlation between stenosis degree and ADC values were noted (p < 0.001). In the comparison of stenotic levels and non-stenotic levels for the grade 2 patient group, there was a statistically significant decrease in FA values and an increase in ADC values in stenotic levels compared with prestenotic and poststenotic levels (p < 0.05).

Conclusion: DTI and quantitative FA and ADC measurements are candidate imaging techniques for the diagnosis of early-stage CSM, which shows no findings in conventional MRI, and determining the degree of spinal cord injury.