Value of brain fMRI and spine DTI in predicting functional outcomes for patients with cervical spondylotic myelopathy
10.3760/cma.j.issn.0254-1424.2019.09.003
- VernacularTitle: 颅脑fMRI及脊髓弥散张量成像对脊髓型颈椎病患者术后脊髓功能恢复的预测价值分析
- Author:
Yancheng SONG
1
,
2
;
Liqing KANG
3
;
Canghai SHEN
4
;
Lan FU
1
;
Fenghai LIU
1
,
2
;
Yongjian FENG
4
Author Information
1. Cangzhou Central Teaching Hospital, Tianjin Medical University, Cangzhou 061000, China
2. Department of MRI, Cangzhou Central Hospital, Cangzhou 061000, China
3. Department of MRI, Cangzhou Central Hospital, Cangzhou 061000, China
4. Department of Orthopedic Surgery, Cangzhou Central Hospital, Cangzhou 061000, China
- Publication Type:Clinical Trail
- Keywords:
Cervical spondylotic myelopathy;
Functional magnetic resonance imaging;
Cortical reorganization;
Diffusion tensor imaging
- From:
Chinese Journal of Physical Medicine and Rehabilitation
2019;41(9):651-656
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the correlations relating functional MRI (fMRI) and diffusion tensor imaging (DTI) parameters with pre-operative neurological status and post-operative outcomes for patients with cervical spondylotic myelopathy (CSM).
Methods:Eighty-seven CSM patients treated with surgical decompression and 38 healthy counterparts were enrolled as the CSM and control groups respectively. DTI and fMRI of the cervical spine were performed while the subjects performed a finger-tapping task with their right hands before the operation and 6 months later. The control group was evaluated only when they were enrolled. All of the patients were given systematic rehabilitation treatment after the surgery. The Japanese Orthopaedic Association (JOA) scoring system for CSM was used to evaluate neurological status, and a JOA recovery rate <50% was defined as a poor recovery.
Results:Compared with the healthy controls, the pre-operative patients showed significantly higher volume of activation (VOA) in the left precentral gyrus (PrCG), but that had decreased significantly 6 months after the surgery. Before the surgery, the patients′ fractional isotropy (FA) was significantly less than that of the controls, but it had increased significantly 6 months after the operation. There was no difference in VOA in the left postcentral gyrus (PoCG) between the CSM patients and the controls before the surgery. The VOA ratio (PrCG/PoCG), VOA-PrCG, VOA-PoCG and FA were significantly correlated with both the JOA scores and recovery rates. Receiver operating characteristic (ROC) curve analyses were performed for the predictive ability with respect to surgical outcomes. The largest area under the ROC curve was observed for the VOA ratio (0.805), followed by FA (0.740), and the VOA-PrCG (0.715). The fMRI and DTI showed better potential for predicting functional outcomes than with standard MRI parameters. Multivariate logistic regression revealed that the VOA ratio and FA were independently associated with poor outcomes.
Conclusions:fMRI and DTI parameters may be more valuable than conventional MRI results for neurological assessment and prognosis with CSM patients. They can also provide references for making up rehabilitation plans.
