Predictive value of dynamic diffusion tensor imaging in surgical prognosis of patients with cervical spondylotic myelopathy
10.3969/j.issn.1002-1671.2024.09.021
- VernacularTitle:动态扩散张量成像对脊髓型颈椎病患者手术预后的预测价值
- Author:
Xiaoyun WANG
1
;
Rui BAI
;
Yujin ZHANG
;
Xiaonan TIAN
;
Di ZHANG
;
Yong WANG
;
Li ZHANG
Author Information
1. 河北医科大学医学影像学院,河北 石家庄 050000
- Keywords:
cervical spondylotic myelopathy;
diffusion tensor imaging;
magnetic resonance imaging;
prognosis;
risk factors
- From:
Journal of Practical Radiology
2024;40(9):1489-1493
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the predictive value of dynamic diffusion tensor imaging(DTI)in the postoperative efficacy of cervical spondylotic myelopathy(CSM)and to determine whether DTI parameters in different positions can be used as predictors of poor neurological prognosis.Methods A total of 105 CSM patients who underwent cervical spine decompression surgery were included.The modified Japanese Orthopedic Association(mJOA)score was used to assess patients'neurological function before surgery and one year after surgery.Patients were divided into two groups based on the recovery rate:the good prognosis group(recovery rate ≥50％)(44 cases)and the poor prognosis group(recovery rate＜50％)(61 cases).Univariate analysis was performed based on patients'clinical characteristics,imaging features and dynamic DTI parameters.Significant variables were subjected to binary logistic regres-sion analysis to identify risk factors for poor postoperative prognosis in CSM patients.Results Univariate analysis results showed significant differences between the two groups in terms of diabetes,number of compression segments,pre-mJOA score,cross-sectional area of the spinal canal at the narrowest location[Area-N(natu-ral),Area-E(extension),Area-F(flexion)],apparent diffusion coefficient(ADC)(ADC-N,ADC-E,ADC-F)and fractional ani-sotropy(FA)(FA-N,FA-E,FA-F)(P＜0.05).Binary logistic regression analysisrevealed that Area-N[odds ratio(OR)0.226;95％confidence interval(CI)0.069-0.732,P=0.013],FA-N(OR 3.028;95％CI 1.12-8.19,P=0.029),Area-E(OR 0.248;95％CI 0.076-0.814,P=0.021),FA-E(OR 4.793;95％CI 1.737-13.228,P=0.002),Area-F(OR 0.288;95％CI 0.095-0.87,P=0.027),FA-F(OR 2.964;95％CI 1.126-7.801,P=0.028)were independent risk factors for poor prognosis.FA-E had significant predictive value for poor prognosis in CSM patients.Conclusion Dynamic DTI can predict the postoperative outcomes in CSM,and FA-E value can serve as an excellent predictor of poor neurological prognosis.
