F. Gelbert A. Henon, J.B. Gayet, N. Bouzar M. Perrin, L. Balabaud C. Mazel, R. Palau PARIS (France). DIFFUSION TENSOR TRACTOGRAPHY OF THE SPINAL CORD. Cervical spondylolis is found in 75% of patients over 65 years.
Cervical myelopathy is caused by chronic segmental compression of the spinal cord because of spondylotic changes.
The initial cause is thought to be a continuous or intermittent compression or pinching of the cord, which results in chronic hypoperfusion.
15 males/15 females;
Age ranged from 34 to 79 years - mean age 50-65;
16 patients presented
with cervical and/or cervico brachial pain
with walking impairement
and clinical suspicion of cervical myelopathy
Signa GE 1.5T HDxt MRI scanner
CTL coil in SAG T1, SAG T2 , AX T2
Diffusion protocolwasperformedusing a SE EPI sequence in both
Sagittal and Axial plans
b value of 750 s/mm2
9 encoding directions
In microscopicscale, water moleculesrandomly diffuses in isotropicenvironment (brownian motion) and in spinal cord water molecules diffuses mainlyalongfibers.
Knowing diffusion direction itis possible to reconstructfiber bundle of the spinal cord.
Normal examination : 9 patients
Focal cervical stenosiswithout spinal signal abnormality : 14 patients
Cervical stenosis and spinal signal abnormality: 6 patients
Otherdiagnosis: 1 SEP,1 syrinx
normal ADC and FA values
The calculation of FA and ADC was possible in all patients.
ADC and FA measurements were reproductible in a same patients with different reviewers and we obtained a constant average of value in normal spinal cord
We observed ADC and FA abnormal values in all cases of signal abnormalities
We also observed ADC and FA abnormal values in 5 patients with clinincal symptoms and no signal abnormality
This focuse the potential interest of this methods to detect earlier stages of spinal cord suffering
These preliminary results must encourage us to include this sequence in the MR protocol of potential spinal cord lesions
Axial or sagittal ? Both!!