Nomogram for predicting the postoperative efficacy of cervical spondylotic myelopathy based on apparent diffusion coefficient and clinical features
10.3969/j.issn.1002-1671.2025.04.006
- VernacularTitle:基于表观扩散系数和临床特征的列线图预测脊髓型颈椎病的术后疗效
- Author:
Jia LI
1
;
Xiaonan TIAN
;
Yujin ZHANG
;
Baogen ZHAO
;
Yong WANG
;
Li ZHANG
Author Information
1. 唐山市人民医院介入科,河北 唐山 063001
- Publication Type:Journal Article
- Keywords:
cervical spondylotic myelopathy;
apparent diffusion coefficient;
nomogram
- From:
Journal of Practical Radiology
2025;41(4):564-568
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the value of the nomogram model based on the apparent diffusion coefficient(ADC)value of the cervical spinal cord in predicting neurological recovery after cervical spondylotic myelopathy(CSM).Methods One hundred CSM patients undergoing decompression surgery were prospectively enrolled.All patients underwent conventional cervical spine MRI and sagittal position non-shared incentive diffusion weighted imaging(ZOOM-DWI)examination before surgery.The improvement rate of neurological function was calculated according to the modified Japanese Orthopaedic Association(mJOA)score before and 6 months after surgery and divided into the good improvement group(60 patients)and the poor improvement group(40 patients)according to the improvement rate.Independent risk factors for postoperative outcomes were determined by univariate and multivariate logistic regression.Then the prediction model based on the clinical-imaging feature(model 1)and clinical-imaging feature-ADC value(model 2)were established,the receiver operating characteristic(ROC)curve was drawn,and the DeLong test was performed to compare the discrimination efficiency of the two models.A nomogram,calibration curve,and clinical decision curve were drawn for model 2.Results Age,body mass index(BMI),diabetes mellitus,T2 hyperintense,cross-sectional area,and ADC values at the disc level of different segments were independent risk factors affecting the outcome of CSM.The area under the curve(AUC)of the ROC curve constructed by model 2(AUC=0.933)was higher than that of model 1(AUC=0.864).The DeLong test showed that the difference between the two models was statistically significant(P＜0.05).The nomogram,calibration curve,and decision curve analysis(DCA)of model 2 showed that it had good differentiation,accuracy,and clinical value.Conclusion The nomogram model based on ADC value can effectively predict the outcome of postoperative neurological recovery in CSM patients.
