当前位置： SCI文献检索 > SPINE期刊下所有文献 > The Relationship Between MRI Signal Intensity Changes, Clinical Presentation, and Surgical Outcome in Degenerative Cervical Myelopathy: Analysis of a Global Cohort.

The Relationship Between MRI Signal Intensity Changes, Clinical Presentation, and Surgical Outcome in Degenerative Cervical Myelopathy: Analysis of a Global Cohort.

Abstract：

STUDY DESIGN:Retrospective analysis of prospective data. OBJECTIVE:To assess the relationship between MRI signal intensity changes, clinical presentation, and surgical outcome in degenerative cervical myelopathy (DCM). SUMMARY OF BACKGROUND DATA:Several studies have sought to assess the extent of spinal cord dysfunction and the potential for postoperative neurological recovery through the evaluation of spinal cord signal change on T2-weighted (T2WI) and T1-weighted images (T1WI). There remains ambiguity if T2WI and T1WI signal changes (1) relate to baseline severity, and (2) predict neurological recovery after surgical treatment. METHODS:Four hundred nineteen MRIs from two prospective multicenter studies were examined. Images were assessed for the presence, levels, and location of spinal cord signal intensity changes and compared with clinical data. Signal changes were also evaluated for the prediction of 2-year postoperative outcome using mJOA parameters. RESULTS:MRIs were categorized by T1WI and T2WI signal change: no signal change (28.9%), T2WI hyperintensity-only (T2WI-only, 51.8%), and T2WI-hyperintensity and T1WI-hypointensity (T1WI+T2WI, 19.3%). T2WI-hyperintensity was present at multiple levels in 27% of patients overall. Baseline severity increased from no signal change to T2WI-only to T2WI+T1WI (P < 0.0001), and there was an incremental increase in the frequency of signs/symptoms. There were no differences in outcomes between no signal change and T2WI-only groups. The presence of T1WI-hypointensity correlated with reduced recovery ratio (P = 0.03) and likelihood of an optimal surgical outcome (P = 0.005), adjusting for baseline mJOA. A greater number of T2WI-hyperintensity levels was also associated with worse baseline severity (P < 0.0001) and recovery ratio (P = 0.001). CONCLUSION:This analysis of a global cohort of DCM patients shows a stepwise trend toward increasing impairment from no signal change to T2WI-hypertensity to T1WI-hypointensity. T1WI signal change indicates more permanent injury, portending decreased functional recovery. T2WI-hyperintensity alone does not predict outcomes. Multiple levels of T2WI-hyperintensity suggest additional tissue injury, correlating with worse clinical impairment and recovery potential. LEVEL OF EVIDENCE:2.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Nouri A,Martin AR,Kato S,Reihani-Kermani H,Riehm LE,Fehlings MG

doi

10.1097/BRS.0000000000002234

subject

Has Abstract

pub_date

2017-12-15 00:00:00

pages

1851-1858

issue

eissn

0362-2436

issn

1528-1159

pii

00007632-201712150-00008

journal_volume

pub_type

杂志文章,多中心研究

在线工具

The Relationship Between MRI Signal Intensity Changes, Clinical Presentation, and Surgical Outcome in Degenerative Cervical Myelopathy: Analysis of a Global Cohort.