American Journal of Neuroradiology 26:1587-1594, June-July 2005
© 2005 American Society of Neuroradiology
SPINE
MR Diffusion Tensor Imaging and Fiber Tracking in Spinal Cord Compression
a Department of Neuroradiology, C.H.U. de Bicêtre, Paris XI University, Le Kremlin-Bicêtre, France
b Department of Neurosurgery, C.H.U. de Bicêtre, Paris XI University, Le Kremlin-Bicêtre, France
c Department of Biostatistics, Institut Curie, Paris V University, Paris, France
d Department of Computer Science, University of North Carolina, Chapel Hill, NC
Address correspondence to Denis Ducreux, Department of Neuroradiology, CHU de Bicêtre, Paris XI University, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France
BACKGROUND AND PURPOSE: Spinal cord damage can result in major functional disability. Alteration of the spinal cord structural integrity can be assessed by using diffusion tensor imaging methods. Our objective is to evaluate the diagnostic accuracy of apparent diffusion coefficient (ADC), fractional anisotropy (FA), and fiber tracking in both acute and slowly progressive spinal cord compressions.
METHODS: Fifteen patients with clinical symptoms of acute (n = 2) or slowly progressive (n = 13) spinal cord compression and 11 healthy volunteers were prospectively selected. We performed T2-weighted fast spin echo (FSE) and diffusion tensor imaging by using a 1.5-T MR scanner. ADC and FA maps were computed. Regions of interest were placed at the cervical, upper and lower thoracic cord levels for the healthy subjects and on the area with abnormal T2-weighted signal intensity in the patients with cord compression. In three patients, we used fiber tracking to locate the areas of cord compression precisely. Data were analyzed by using a mixed model. The sensitivity (SE) and specificity (sp) of imaging (T2, ADC, and FA maps) in the detection of spinal cord abnormality were statistically evaluated.
RESULTS: For the healthy subjects, averaged ADC values ranged from 0.96 10–3 mm2/s to 1.05 10–3 mm2/s and averaged FA values ranged from 0.745 to 0.751. Ten patients had decreased FA (0.67 ± 0.087), and one had increased FA values (0.831); only two patients had increased ADC values (1.03 ± 0.177). There was a statistically significant difference in the FA values between volunteers and patients (P = .012). FA had a much higher sensitivity (SE = 73.3%) and specificity (sp = 100%) in spinal cord abnormalities detection compared with T2-weighted FSE imaging (se = 46.7%, sp = 100%) and ADC (SE = 13.4%, sp = 80%).
CONCLUSIONS: FA has the highest sensitivity and specificity in the detection of acute spinal cord abnormalities. Spinal cord fiber tracking is a useful tool to focus measurements on the compressed spinal cord.
This article has been cited by other articles:
 |
|
 |
|
  S M Hatem, N Attal, D Ducreux, M Gautron, F Parker, L Plaghki, and D Bouhassira Assessment of spinal somatosensory systems with diffusion tensor imaging in syringomyelia J. Neurol. Neurosurg. Psychiatry, December 1, 2009; 80(12): 1350 - 1356. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Roze, P. Bounolleau, D. Ducreux, V. Cochen, S. Leu-Semenescu, Y. Beaugendre, M. C. Lavallard-Rousseau, A. Blancher, F. Bourdain, P. Dupont, et al. Propriospinal myoclonus revisited: Clinical, neurophysiologic, and neuroradiologic findings Neurology, April 14, 2009; 72(15): 1301 - 1309. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B.M. Ellingson, J.L. Ulmer, S.N. Kurpad, and B.D. Schmit Diffusion Tensor MR Imaging in Chronic Spinal Cord Injury AJNR Am. J. Neuroradiol., November 1, 2008; 29(10): 1976 - 1982. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B.M. Ellingson, J.L. Ulmer, S.N. Kurpad, and B.D. Schmit Diffusion Tensor MR Imaging of the Neurologically Intact Human Spinal Cord AJNR Am. J. Neuroradiol., August 1, 2008; 29(7): 1279 - 1284. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. W. Lee, K. S. Park, J. H. Kim, J.-Y. Choi, S. H. Hong, S.-H. Park, and H. S. Kang Diffusion Tensor Imaging in Idiopathic Acute Transverse Myelitis Am. J. Roentgenol., August 1, 2008; 191(2): W52 - W57. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Fujiyoshi, M. Yamada, M. Nakamura, J. Yamane, H. Katoh, K. Kitamura, K. Kawai, S. Okada, S. Momoshima, Y. Toyama, et al. In Vivo Tracing of Neural Tracts in the Intact and Injured Spinal Cord of Marmosets by Diffusion Tensor Tractography J. Neurosci., October 31, 2007; 27(44): 11991 - 11998. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Ozanne, T. Krings, D. Facon, P. Fillard, J.L. Dumas, H. Alvarez, D. Ducreux, and P. Lasjaunias MR Diffusion Tensor Imaging and Fiber Tracking in Spinal Cord Arteriovenous Malformations: A Preliminary Study AJNR Am. J. Neuroradiol., August 1, 2007; 28(7): 1271 - 1279. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Lacout, S. Binsse, E.-H. Mostafa, J. Renoux, D. Facon, I. Huynh, P. Lasjaunias, D. Ducreux, and P. Fillard Comparison between diffusion tensor imaging and conventional MR imaging sequences in the detection of spinal cord abnormalities. AJNR Am. J. Neuroradiol., May 1, 2007; 28(5): 806 - 807. [Full Text] [PDF]
|
|
|
|
|
|
J. Renoux, D. Facon, P. Fillard, I. Huynh, P. Lasjaunias, and D. Ducreux MR Diffusion Tensor Imaging and Fiber Tracking in Inflammatory Diseases of the Spinal Cord. AJNR Am. J. Neuroradiol., October 1, 2006; 27(9): 1947 - 1951. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Ducreux, J.-F. Lepeintre, P. Fillard, C. Loureiro, M. Tadie, and P. Lasjaunias MR Diffusion Tensor Imaging and Fiber Tracking in 5 Spinal Cord Astrocytomas AJNR Am. J. Neuroradiol., January 1, 2006; 27(1): 214 - 216. [Abstract] [Full Text] [PDF]
|
|