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Research ArticleSpine Imaging and Spine Image-Guided Interventions

Evaluation of Cervical Myelopathy Using Apparent Diffusion Coefficient Measured by Diffusion-Weighted Imaging

T. Sato, T. Horikoshi, A. Watanabe, M. Uchida, K. Ishigame, T. Araki and H. Kinouchi
American Journal of Neuroradiology February 2012, 33 (2) 388-392; DOI: https://doi.org/10.3174/ajnr.A2756
T. Sato
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T. Horikoshi
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A. Watanabe
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M. Uchida
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K. Ishigame
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T. Araki
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H. Kinouchi
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  • Fig 1.
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    Fig 1.

    Axial view of DWI. The mean ADC was calculated in the region of interest. The region of interest covered most of the cross-section of spinal cord, excluding the CSF space.

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    Fig 2.

    Grades of spinal cord compression on MR imaging. Type 0 indicates no compression; type 1, disappearance of CSF space; type 2, mild compressive deformity of spinal cord; and type 3, marked deformity (flattening) of the spinal cord.

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    Fig 3.

    The relationship between preoperative JOA scores and ADC values in all patients. Patients with ADC values of ≥0.9 × 10−3 mm2/s had lower JOA scores (P = .0085).

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    Fig 4.

    Recovery rates of JOA scores and preoperative ADC values in 18 patients followed for >6 months. Patients with an ADC of <0.7 × 10−3 mm2/s tended to show better recovery rates than those with an ADC of 0.9 × 10−3 mm2/s (P = .0636).

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    Table 1:

    Chronologic changes of mean ADC values in each compression type

    TypePreoperative StagePostoperative Stage (1 wk)Follow-Up Stage (6 mo)
    00.704 ± 0.142 (n = 140)0.692 ± 0.134 (n = 114)0.648 ± 0.143 (n = 84)a
    I0.833 ± 0.228 (n = 75)b0.807 ± 0.171 (n = 63)c0.676 ± 0.093 (n = 49)d
    II0.939 ± 0.330 (n = 74)b0.880 ± 0.238 (n = 67)e0.763 ± 0.150 (n = 57)f,g
    III0.948 ± 0.289 (n = 33)b0.908 ± 0.197 (n = 28)h0.791 ± 0.153 (n = 23)
    Total0.813 ± 0.254 (n = 322)0.723 ± 0.191 (n = 272)0.691 ± 0.145 (n = 213)i
    • Note:—Values are expressed as mean (×10 − 3 mm2/s).

    • ↵a P = .01 versus type 0 in the preoperative stage.

    • ↵b P <.0001 versus type 0 in the preoperative stage.

    • ↵c P = .0008.

    • ↵d P = .0015 versus type I in the preoperative stage.

    • ↵e P < .0001.

    • ↵f P = .004 versus type 0 in the follow-up stage.

    • ↵g P = .009 versus type II in the preoperative stage.

    • ↵h P = .005 versus type 0 in the postoperative stage.

    • ↵i P < .0001 versus total value in the preoperative stage.

    • View popup
    Table 2:

    Type of spinal cord compression and occurrence of high T2 signal intensity

    TypeISI (+)
    0 (n = 140)8 (5.7%)
    I (n = 75)8 (10.7%)
    II (n = 74)14 (18.9%)a
    III (n = 33)18 (54.5%)b
    Total (n = 322)48/322 (14.9%)
    • Note:—ISI indicates increased signal intensity.

    • ↵a P = .004.

    • ↵b P < .0001 versus type 0.

    • View popup
    Table 3:

    Chronologic changes of mean ADC values in high T2 signal intensity

    Preoperative StagePostoperative Stage (1 wk)Follow-Up Stage (6 mo)
    ISI (+)1.002 ± 0.305 (n = 48)0.905 ± 0.255 (n = 41)0.782 ± 0.147 (n = 32)a
    ISI (−)0.775 ± 0.126 (n = 274)b0.760 ± 0.178 (n = 231)c0.674 ± 0.141 (n = 181)d
    Total0.813 ± 0.254 (n = 322)0.723 ± 0.191 (n = 272)0.691 ± 0.145 (n = 213)
    • Note:—ISI indicates increased signal intensity. Values are expressed as mean (×10−3 mm2/s).

    • ↵a P = .02 versus ISI(+) group in the preoperative stage.

    • ↵b P < .0001 versus ISI(+) group in the preoperative stage.

    • ↵c P = .001 versus ISI(+) group in the postoperative stage.

    • ↵d P <.0001 versus ISI(−) group in the preoperative stage.

    • View popup
    Table 4:

    Chronologic changes of mean JOA score and compression group and high T2 signal intensity

    PreoperativePostoperative (1 wk)Recovery RateFollow-Up (6 mo)Recovery Rate
    Type 013.7 ± 2.75 (n = 4)16.8 ± 0.35 (n = 3)83.4 ± 23.517 (n = 2)100
    Type I14.1 ± 3.50 (n = 8)15.9 ± 2.17 (n = 7)a75.5 ± 28.417 (n = 4)b100
    Type II11.1 ± 3.44 (n = 27)14.1 ± 2.58 (n = 25)c57.5 ± 29.814.9 ± 2.16 (n = 21)d72.7 ± 31.4
    Type III9.9 ± 3.47 (n = 27)e13.2 ± 3.36 (n = 24)f50.3 ± 28.616.1 ± 1.50 (n = 21)g84.3 ± 19.1
    Total11.0 ± 3.6 (n = 66)14.0 ± 2.9 (n = 59)15.7 ± 1.9 (n = 48)
    ISI(−)11.9 ± 3.54 (n = 34)15.2 ± 1.95 (n = 30)h66.2 ± 27.616.4 ± 0.97 (n = 20)i86.6 ± 21.6
    ISI(+)10.2 ± 3.65 (n = 32)13.1 ± 3.28 (n = 29)j,k49.2 ± 29.9l15.5 ± 1.85 (n = 28)m77.6 ± 28.2
    Total11.0 ± 3.6 (n = 66)14.0 ± 2.9 (n = 59)15.7 ± 1.9 (n = 48)
    • Note:—ISI indicates increased signal intensity. Values are expressed as means.

    • ↵a P = .02.

    • ↵b P = < .0001 versus type 1 in the preoperative state.

    • ↵c P = .003.

    • ↵d P = .02 versus type II in the preoperative stage.

    • ↵e P = .007.

    • ↵f P = .0002.

    • ↵g P = .0001 versus type III in the preoperative stage.

    • ↵h P = .0001.

    • ↵i P = .0002 versus ISI(−) group in the preoperative state

    • ↵j P = .009 versus the ISI(−) group in the postoperative stage.

    • ↵k P = .004.

    • ↵l P = .04 versus the ISI(−) group.

    • ↵m P = .0001 versus ISI(+) in the preoperative stage.

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American Journal of Neuroradiology: 33 (2)
American Journal of Neuroradiology
Vol. 33, Issue 2
1 Feb 2012
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T. Sato, T. Horikoshi, A. Watanabe, M. Uchida, K. Ishigame, T. Araki, H. Kinouchi
Evaluation of Cervical Myelopathy Using Apparent Diffusion Coefficient Measured by Diffusion-Weighted Imaging
American Journal of Neuroradiology Feb 2012, 33 (2) 388-392; DOI: 10.3174/ajnr.A2756

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Evaluation of Cervical Myelopathy Using Apparent Diffusion Coefficient Measured by Diffusion-Weighted Imaging
T. Sato, T. Horikoshi, A. Watanabe, M. Uchida, K. Ishigame, T. Araki, H. Kinouchi
American Journal of Neuroradiology Feb 2012, 33 (2) 388-392; DOI: 10.3174/ajnr.A2756
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