Article Figures & Data
Figures
- Fig 1.
A, MR imaging of a spinal cord compression due to a breast tumor metastasis in patient 1. Images are from C7–T10. Color-coded scale related to parameters values. Higher values are coded in red, medium values in green, and lower values in blue. T2-weighted imaging (first image) shows a high signal intensity (white arrow), ADC (second image) is slightly increased (blue-green areas; ADC = 1.1 10−3 mm2/s versus 0.84 10−3 mm2/s in normal cervicothoracic area) and FA (third image) is decreased (green areas; FA = 0.61 vs 0.75 in normal cervicothoracic area) after region of interest measurements. The region of interest in abnormal area was drawn by using the fiber tracking three-dimensional reconstruction.
B, MR imaging of a spinal cord compression due to a breast tumor metastasis with epidural involvement in patient 1. Fiber tracking over b0 image shows a mass-effect on fibers tracts. The region of interest (green area) was drawn over the maximal level of compression (blue arrow) and then automatically reported on the coregistered ADC and FA maps to measure ADC and FA values in the compression site.
- Fig 2.
Time course from d1 to d30 of the averaged FA parameter estimated from the compression sites in 11 patients with abnormal FA values. FA values decreased from the 1st to the 21st days, then slightly increased, both related to the extracellular water diffusivity: restricted diffusivity in acute stage and increased diffusivity in chronic stage. Normal values range from 0.69 to 0.8.
- Fig 3.
Fiber tracking performed on a volunteer’s cervical spinal cord. Sagittal (A), axial (B), and coronal (C) views show tracts reconstructed over the b0 sequence. Main white matter tracts are visible on axial (B) and coronal (C) views of the three-dimensional reconstructions: two individualized posterior lemniscal tracts (arrowheads), and posterolateral corticospinal tracts (arrows). Other tracts are visible, but have to be more correlated with known anatomy.
- Fig 4.
Three-dimensional reconstructions are mapped over the b0 images. Fiber tracking performed on the spinal cord volunteer shows some pitfalls of the FT method due to magnetic susceptibility effect of the DTI MR image: “hole” effect, gap in three-dimensional reconstruction (blue arrows).
Tables
Patient (no.) Sex/Age Symptoms IOT C/ICL T2 SI ADC FA Diagnoses 1 M/60 MD + Thoracic Pain 7 T9 Normal 1.1 0.61 Metastasis 2 F/80 Thoracic Pain 1 T6 High 1.06 0.831 Metastasis 3 M/59 MD 7 T1–T3 High 0.82 0.78 Metastasis 4 M/76 MD + SD >30 C1–C2 High 1.41 0.526 Degenerative 5 M/43 MD 15 C6–C7 Normal 1.17 0.73 Degenerative 6 M/62 MD >30 C5–C7 High 1.26 0.642 Degenerative 7 M/40 SD >30 T4–T5 Normal 1.03 0.736 Degenerative 8 F/41 Cervical Pain 15 C3–C4 Normal 0.85 0.6 Spondylodiscitis 9 F/46 SD 21 C5–C6 Normal 0.91 0.67 Degenerative 10 F/73 SD 3 T6 High 0.775 0.64 Metastasis 11 M/34 SD + Lumbar Pain >30 T12–L1 Normal 1.08 0.599 Spondylodiscitis 12 M/77 MD 1 T6–T7 High 1.19 0.8 Spondylodiscitis 13 M/30 MD + SD >30 C6 Normal 0.97 0.676 Spondylodiscitis 14 F/48 MD >30 C5–C7 High 0.88 0.614 Spondylodiscitis 15 M/40 MD 21 C4–C5 Normal 1.08 0.6 Degenerative Note.—Abnormal values are in red. Imaging compression level matched the clinical data.
IOT = imaging/onset time: time between MR exam and onset of symptoms (in days); C/ICL = clinical/imaging compression level; SI = signal intensity; MD = motor deficit; SD = sensitive deficit; ADC = apparent diffusion coefficient (%10−3 mm2/s); FA = fractional anisotropy.
Average SD Median Minimum Maximum MD P Value FA 0.748 0.027 0.743 0.700 0.800 7 Cervical 0.748 0.031 0.747 0.700 0.780 1 .86 High thoracic 0.751 0.027 0.740 0.720 0.800 2 .67 Low thoracic 0.745 0.027 0.74 0.714 0.800 4 – ADC (%10−3) 1.00 0.130 1.00 0.77 1.25 7 Cervical 1.01 0.157 1.02 0.77 1.25 1 .36 High thoracic 0.96 0.104 0.93 0.81 1.13 2 – Low thoracic 1.05 0.111 1.06 0.89 1.19 4 .15 Note.—Comparison of FA and ADC values according to medullar level on healthy volunteers doesn’t show a statistically significant difference. SD = standard deviation; MD = patient distribution (number of patients).
Average SD Median Minimum Maximum MD P Value FA .42 Healthy volunteers 0.748 0.027 0.743 0.700 0.800 7 Patients 0.740 0.034 0.750 0.690 0.780 0 ADC (%10−3) .26 Healthy volunteers 1.00 0.130 1.00 0.77 1.25 7 Patients 0.949 0.172 0.928 0.730 1.34 0 Note.—Comparison of FA and ADC of healthy level on healthy volunteers and patients doesn’t show a statistically significant difference. SD = standard deviation; MD = patient distribution (number of patients).
Average SD Median Minimum Maximum MD P Value FA .012 Healthy level 0.740 0.034 0.750 0.690 0.780 0 Pathologic 0.670 0.087 0.642 0.526 0.831 0 ADC (%10−3) .13 Healthy level 0.949 0.172 0.928 0.730 1.34 0 Pathologic 1.03 0.177 1.03 0.775 1.41 0 Note.—Comparison of FA and ADC of pathologic and healthy levels in patients doesn’t show a statistically significant difference for ADC but shows one for FA (bold value). SD = standard deviation; MD = patient distribution (number of patients).
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