Analysis of ascending spinal tract degeneration in cervical spondylotic myelopathy using 3D anisotropy contrast single-shot echo planar imaging on a 3.0-T system

J Neurosurg Spine. 2011 Dec;15(6):648-53. doi: 10.3171/2011.7.SPINE10843. Epub 2011 Sep 9.

Abstract

Object: The authors assessed the role of 3D anisotropy contrast (3DAC) in evaluating specific ascending tract degeneration in patients with cervical spondylotic myelopathy (CSM).

Methods: The authors studied 10 patients (2 women, 8 men; mean age 59.8 ± 14.6 years) with CSM and spinal cord compression below the C2-3 disc level, as well as 10 healthy control individuals (3 women, 7 men; mean age 42.0 ± 24.1 years). Images of the cervical cord at the C2-3 level were obtained using a 3.0-T MR imaging system.

Results: Three-dimensional anisotropy contrast imaging clearly made possible tract-by-tract analysis of the fasciculus cuneatus, fasciculus gracilis, and spinocerebellar tract. Tract degeneration identified using 3DAC showed good correlation with a decline in fractional anisotropy. Degeneration of the fasciculus gracilis detected by "vector contrast" demonstrated a good correlation with Nurick grades.

Conclusions: The study unambiguously demonstrated that 3DAC imaging is capable of assessing ascending tract degeneration in patients with CSM. Degeneration of an individual tract can be easily identified as a vector contrast change on the 3DAC image, a reflection of quantitative changes in anisotropism, similar to fractional anisotropy. Excellent correlation between Nurick grades and fasciculus gracilis degeneration suggests potential application of 3DAC imaging for tract-by-tract clinical correlation.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anisotropy
  • Cervical Vertebrae / pathology
  • Echo-Planar Imaging / instrumentation
  • Echo-Planar Imaging / methods*
  • Female
  • Humans
  • Imaging, Three-Dimensional / instrumentation
  • Imaging, Three-Dimensional / methods*
  • Male
  • Middle Aged
  • Models, Neurological
  • Nerve Degeneration / etiology
  • Nerve Degeneration / pathology
  • Spinal Cord Compression / etiology
  • Spinal Cord Compression / pathology*
  • Spinocerebellar Tracts / pathology*
  • Spondylosis / complications
  • Spondylosis / pathology*
  • Young Adult