Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
European Spine Journal
Erschienen in: European Spine Journal 2/2015

01.04.2015 | Review Article

Advances in MR imaging for cervical spondylotic myelopathy

verfasst von: Benjamin M. Ellingson, Noriko Salamon, Langston T. Holly

Erschienen in: European Spine Journal | Sonderheft 2/2015

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To outline the pathogenesis of cervical spondylotic myelopathy (CSM), the correlative abnormalities observed on standard magnetic resonance imaging (MRI), the biological implications and current status of diffusion tensor imaging (DTI), and MR spectroscopy (MRS) as clinical tools, and future directions of MR technology in the management of CSM patients.

Methods

A systematic review of the pathogenesis and current state-of-the-art in MR imaging technology for CSM was performed.

Results

CSM is caused by progressive, degenerative, vertebral column abnormalities that result in spinal cord damage related to both primary mechanical and secondary biological injuries. The T2 signal change on conventional MRI is most commonly associated with neurological deficits, but tends not to be a sensitive predictor of recovery of function. DTI and MRS show altered microstructure and biochemistry that reflect patient-specific pathogenesis.

Conclusion

Advanced imaging techniques, including DTI and MRS, show higher sensitivity to microstructural and biochemical changes within the cord, and may aid in management of CSM patients.
Literatur
1.
Song T, Chen WJ, Yang B, Zhao HP, Huang JW, Cai MJ, Dong TF, Li TS (2011) Diffusion tensor imaging in the cervical spinal cord. Eur Spine J 20:422–428CrossRefPubMedCentralPubMed
2.
Demir A, Ries M, Moonen CT, Vital JM, Dehais J, Arne P, Caille JM, Dousset V (2003) Diffusion-weighted MR imaging with apparent diffusion coefficient and apparent diffusion tensor maps in cervical spondylotic myelopathy. Radiology 229:37–43CrossRefPubMed
3.
Facon D, Ozanne A, Fillard P, Lepeintre JF, Tournoux-Facon C, Ducreux D (2005) MR diffusion tensor imaging and fiber tracking in spinal cord compression. AJNR Am J Neuroradiol 26:1587–1594PubMed
4.
Hernandez E, Mackay AL, MacMillan EL, Madler B, Li DK, Dvorak MF, Cordova T, Ramirez-Manzanares A, Laule C (2009) Diffusion tensor imaging of subjects with cervical spondylotic myelopathy: use of the eigenvalues as indicators of spinal stenosis. Proc Intl Soc Mag Reson Med 17:1309
5.
Jones JG, Cen SY, Lebel RM, Hsieh PC, Law M (2012) Diffusion tensor imaging correlates with the clinical assessment of disease severity in cervical spondylotic myelopathy and predicts outcome following surgery. AJNR Am J Neuroradiol 34:471–478CrossRefPubMed
6.
Holly LT, Freitas B, McArthur DL, Salamon N (2009) Proton magnetic resonance spectroscopy to evaluate spinal cord axonal injury in cervical spondylotic myelopathy. J Neurosurg Spine 10:194–200CrossRefPubMed
7.
Fehlings MG, Skaf G (1998) A review of the pathophysiology of cervical spondylotic myelopathy with insights for potential novel mechanisms drawn from traumatic spinal cord injury. Spine (Phila Pa 1976) 23:2730–2737CrossRef
8.
Fujiwara K, Yonenobu K, Ebara S, Yamashita K, Ono K (1989) The prognosis of surgery for cervical compression myelopathy. An analysis of the factors involved. J Bone Joint Surg Br 71:393–398PubMed
9.
Henderson FC, Geddes JF, Vaccaro AR, Woodard E, Berry KJ, Benzel EC (2005) Stretch-associated injury in cervical spondylotic myelopathy: new concept and review. Neurosurgery 56:1101–1113 (discussion 1101–1113)PubMed
10.
Kim DH, Vaccaro AR, Henderson FC, Benzel EC (2003) Molecular biology of cervical myelopathy and spinal cord injury: role of oligodendrocyte apoptosis. Spine J 3:510–519CrossRefPubMed
11.
Yamaura I, Yone K, Nakahara S, Nagamine T, Baba H, Uchida K, Komiya S (2002) Mechanism of destructive pathologic changes in the spinal cord under chronic mechanical compression. Spine (Phila Pa 1976) 27:21–26CrossRef
12.
Baptiste DC, Fehlings MG (2006) Pathophysiology of cervical myelopathy. Spine J 6:190S–197SCrossRefPubMed
13.
Wada E, Yonenobu K, Suzuki S, Kanazawa A, Ochi T (1999) Can intramedullary signal change on magnetic resonance imaging predict surgical outcome in cervical spondylotic myelopathy? Spine (Phila Pa 1976) 24:455–461 (discussion 462)CrossRef
14.
Matsuda Y, Miyazaki K, Tada K, Yasuda A, Nakayama T, Murakami H, Matsuo M (1991) Increased MR signal intensity due to cervical myelopathy. Analysis of 29 surgical cases. J Neurosurg 74:887–892CrossRefPubMed
15.
Mehalic TF, Pezzuti RT, Applebaum BI (1990) Magnetic resonance imaging and cervical spondylotic myelopathy. Neurosurgery 26:217–226 (discussion 217–226)CrossRefPubMed
16.
Yukawa Y, Kato F, Yoshihara H, Yanase M, Ito K (2007) MR T2 image classification in cervical compression myelopathy: predictor of surgical outcomes. Spine (Phila Pa 1976) 32:1675–1678 (discussion 1679)CrossRef
17.
Kadanka Z, Bednarik J, Vohanka S, Vlach O, Stejskal L, Chaloupka R, Filipovicova D, Surelova D, Adamova B, Novotny O, Nemec M, Smrcka V, Urbanek I (2000) Conservative treatment versus surgery in spondylotic cervical myelopathy: a prospective randomised study. Eur Spine J 9:538–544CrossRefPubMedCentralPubMed
18.
Mummaneni PV, Kaiser MG, Matz PG, Anderson PA, Groff M, Heary R, Holly L, Ryken T, Choudhri T, Vresilovic E, Resnick D (2009) Preoperative patient selection with magnetic resonance imaging, computed tomography, and electroencephalography: does the test predict outcome after cervical surgery? J Neurosurg Spine 11:119–129CrossRefPubMed
19.
Mastronardi L, Elsawaf A, Roperto R, Bozzao A, Caroli M, Ferrante M, Ferrante L (2007) Prognostic relevance of the postoperative evolution of intramedullary spinal cord changes in signal intensity on magnetic resonance imaging after anterior decompression for cervical spondylotic myelopathy. J Neurosurg Spine 7:615–622CrossRefPubMed
20.
Park YS, Nakase H, Kawaguchi S, Sakaki T, Nikaido Y, Morimoto T (2006) Predictors of outcome of surgery for cervical compressive myelopathy: retrospective analysis and prospective study. Neurol Med Chir (Tokyo) 46:231–239CrossRef
21.
Ito T, Oyanagi K, Takahashi H, Takahashi HE, Ikuta F (1996) Cervical spondylotic myelopathy. Clinicopathologic study on the progression pattern and thin myelinated fibers of the lesions of seven patients examined during complete autopsy. Spine (Phila Pa 1976) 21:827–833CrossRef
22.
Basser PJ, Mattiello J, LeBihan D (1994) Estimation of the effective self-diffusion tensor from the NMR spin echo. J Magn Reson B 103:247–254CrossRefPubMed
23.
24.
Basser PJ (1995) Inferring microstructural features and the physiological state of tissues from diffusion-weighted images. NMR Biomed 8:333–344CrossRefPubMed
25.
Basser PJ, Pierpaoli C (1996) Microstructural and physiological features of tissues elucidated by quantitative-diffusion-tensor MRI. J Magn Reson B 111:209–219CrossRefPubMed
26.
Pierpaoli C, Basser PJ (1996) Toward a quantitative assessment of diffusion anisotropy. Magn Reson Med 36:893–906CrossRefPubMed
27.
Ellingson BM, Ulmer JL, Schmit BD (2007) Gray and white matter delineation in the human spinal cord using diffusion tensor imaging and fuzzy logic. Acad Radiol 14:847–858CrossRefPubMed
28.
Ennis DB, Kindlmann G (2006) Orthogonal tensor invariants and the analysis of diffusion tensor magnetic resonance images. Magn Reson Med 55:136–146CrossRefPubMed
29.
Ford JC, Hackney DB (1997) Numerical model for calculation of apparent diffusion coefficients (ADC) in permeable cylinders—comparison with measured ADC in spinal cord white matter. Magn Reson Med 37:387–394CrossRefPubMed
30.
Ford JC, Hackney DB, Lavi E, Phillips M, Patel U (1998) Dependence of apparent diffusion coefficients on axonal spacing, membrane permeability, and diffusion time in spinal cord white matter. J Magn Reson Imaging 8:775–782CrossRefPubMed
31.
Nilsson M, Latt J, Stahlberg F, van Westen D, Hagslatt H (2012) The importance of axonal undulation in diffusion MR measurements: a Monte Carlo simulation study. NMR Biomed 25:795–805CrossRefPubMed
32.
Benae JL, Ellingson BM, Kurpad SN, Kocak M, Wang MC (2009) Diffusion tensor MR imaging in degenerative cervical stenosis. In: Congress of Neurological Surgeons Annual Meeting. New Orleans, LA
33.
Mamata H, Jolesz FA, Maier SE (2005) Apparent diffusion coefficient and fractional anisotropy in spinal cord: age and cervical spondylosis-related changes. J Magn Reson Imaging 22:38–43CrossRefPubMed
34.
Uda T, Takami T, Tsuyuguchi N, Sakamoto S, Yamagata T, Ikeda H, Nagata T, Ohata K (2012) Assessment of cervical spondylotic myelopathy using diffusion tensor MRI parameter at 3.0 tesla. Spine (Phila Pa 1976) 38:407–414CrossRef
35.
Hori M, Fukunaga I, Masutani Y, Nakanishi A, Shimoji K, Kamagata K, Asahi K, Hamasaki N, Suzuki Y, Aoki S (2012) New diffusion metrics for spondylotic myelopathy at an early clinical stage. Eur Radiol 22:1797–1802CrossRefPubMedCentralPubMed
36.
Kara B, Celik A, Karadereler S, Ulusoy L, Ganiyusufoglu K, Onat L, Mutlu A, Ornek I, Sirvanci M, Hamzaoglu A (2011) The role of DTI in early detection of cervical spondylotic myelopathy: a preliminary study with 3-T MRI. Neuroradiology 53:609–616CrossRefPubMed
37.
Kerkovsky M, Bednarik J, Dusek L, Sprlakova-Pukova A, Urbanek I, Mechl M, Valek V, Kadanka Z (2012) Magnetic resonance diffusion tensor imaging in patients with cervical spondylotic spinal cord compression: correlations between clinical and electrophysiological findings. Spine (Phila Pa 1976) 37:48–56CrossRef
38.
Budzik JF, Balbi V, Le Thuc V, Duhamel A, Assaker R, Cotten A (2011) Diffusion tensor imaging and fibre tracking in cervical spondylotic myelopathy. Eur Radiol 21:426–433CrossRefPubMed
39.
Hori M, Okubo T, Aoki S, Kumagai H, Araki T (2006) Line scan diffusion tensor MRI at low magnetic field strength: feasibility study of cervical spondylotic myelopathy in an early clinical stage. J Magn Reson Imaging 23:183–188CrossRefPubMed
40.
Lindberg PG, Feydy A, Sanchez K, Rannou F, Maier MA (2011) Measures of spinal canal stenosis and relationship to spinal cord structure in patients with cervical spondylosis. J Neuroradiol 39:236–242CrossRefPubMed
41.
Lee JW, Kim JH, Park JB, Park KW, Yeom JS, Lee GY, Kang HS (2011) Diffusion tensor imaging and fiber tractography in cervical compressive myelopathy: preliminary results. Skeletal Radiol 40:1543–1551CrossRefPubMed
42.
Xiangshui M, Xiangjun C, Xiaoming Z, Qingshi Z, Yi C, Chuanqiang Q, Xiangxing M, Chuanfu L, Jinwen H (2010) 3 T magnetic resonance diffusion tensor imaging and fibre tracking in cervical myelopathy. Clin Radiol 65:465–473CrossRefPubMed
43.
Sato T, Horikoshi T, Watanabe A, Uchida M, Ishigame K, Araki T, Kinouchi H (2012) Evaluation of cervical myelopathy using apparent diffusion coefficient measured by diffusion-weighted imaging. AJNR Am J Neuroradiol 33:388–392CrossRefPubMed
44.
Aota Y, Niwa T, Uesugi M, Yamashita T, Inoue T, Saito T (2008) The correlation of diffusion-weighted magnetic resonance imaging in cervical compression myelopathy with neurologic and radiologic severity. Spine (Phila Pa 1976) 33:814–820CrossRef
45.
Tsuchiya K, Katase S, Fujikawa A, Hachiya J, Kanazawa H, Yodo K (2003) Diffusion-weighted MRI of the cervical spinal cord using a single-shot fast spin-echo technique: findings in normal subjects and in myelomalacia. Neuroradiology 45:90–94PubMed
46.
Wang W, Qin W, Hao N, Wang Y, Zong G (2012) Diffusion tensor imaging in spinal cord compression. Acta Radiol 53:921–928CrossRefPubMed
47.
Cheung MM, Li DT, Hui ES, Fan S, Ding AY, Hu Y, Wu EX (2009) In vivo diffusion tensor imaging of chronic spinal cord compression in rat model. Conf Proc IEEE Eng Med Biol Soc 2009:2715–2718PubMed
48.
Ellingson BM, Ulmer JL, Kurpad SN, Schmit BD (2008) Diffusion tensor MR imaging in chronic spinal cord injury. AJNR Am J Neuroradiol 29:1976–1982CrossRefPubMed
49.
Deo AA, Grill RJ, Hasan KM, Narayana PA (2006) In vivo serial diffusion tensor imaging of experimental spinal cord injury. J Neurosci Res 83:801–810CrossRefPubMed
50.
Harkey HL, al-Mefty O, Marawi I, Peeler DF, Haines DE, Alexander LF (1995) Experimental chronic compressive cervical myelopathy: effects of decompression. J Neurosurg 83:336–341CrossRefPubMed
51.
Bennett MH, McCallum JE (1977) Experimental decompression of spinal cord. Surg Neurol 8:63–67PubMed
52.
DeGirolami U, Zivin JA (1982) Neuropathology of experimental spinal cord ischemia in the rabbit. J Neuropathol Exp Neurol 41:129–149CrossRefPubMed
53.
Gooding MR, Wilson CB, Hoff JT (1975) Experimental cervical myelopathy. Effects of ischemia and compression of the canine cervical spinal cord. J Neurosurg 43:9–17CrossRefPubMed
54.
Hukuda S, Wilson CB (1972) Experimental cervical myelopathy: effects of compression and ischemia on the canine cervical cord. J Neurosurg 37:631–652CrossRefPubMed
55.
Wilson CB, Bertan V, Norrell HA Jr, Hukuda S (1969) Experimental cervical myelopathy. II. Acute ischemic myelopathy. Arch Neurol 21:571–589CrossRefPubMed
56.
Jones J, Lerner A, Kim PE, Law M, Hsieh PC (2011) Diffusion tensor imaging in the assessment of ossification of the posterior longitudinal ligament: a report on preliminary results in 3 cases and review of the literature. Neurosurg Focus 30:E14CrossRefPubMed
57.
Cui JL, Wen CY, Hu Y, Mak KC, Mak KH, Luk KD (2011) Orientation entropy analysis of diffusion tensor in healthy and myelopathic spinal cord. Neuroimage 58:1028–1033CrossRefPubMed
58.
Basser PJ, Pajevic S, Pierpaoli C, Duda J, Aldroubi A (2000) In vivo fiber tractography using DT-MRI data. Magn Reson Med 44:625–632CrossRefPubMed
59.
Mori S, Crain BJ, Chacko VP, van Zijl PC (1999) Three-dimensional tracking of axonal projections in the brain by magnetic resonance imaging. Ann Neurol 45:265–269CrossRefPubMed
60.
Blamire AM, Cader S, Lee M, Palace J, Matthews PM (2007) Axonal damage in the spinal cord of multiple sclerosis patients detected by magnetic resonance spectroscopy. Magn Reson Med 58:880–885CrossRefPubMed
61.
Kendi AT, Tan FU, Kendi M, Yilmaz S, Huvaj S, Tellioglu S (2004) MR spectroscopy of cervical spinal cord in patients with multiple sclerosis. Neuroradiology 46:764–769CrossRefPubMed
62.
Cooke FJ, Blamire AM, Manners DN, Styles P, Rajagopalan B (2004) Quantitative proton magnetic resonance spectroscopy of the cervical spinal cord. Magn Reson Med 51:1122–1128CrossRefPubMed
63.
Yu WR, Baptiste DC, Liu T, Odrobina E, Stanisz GJ, Fehlings MG (2009) Molecular mechanisms of spinal cord dysfunction and cell death in the spinal hyperostotic mouse: implications for the pathophysiology of human cervical spondylotic myelopathy. Neurobiol Dis 33:149–163CrossRefPubMed
64.
Tobias CA, Han SS, Shumsky JS, Kim D, Tumolo M, Dhoot NO, Wheatley MA, Fischer I, Tessler A, Murray M (2005) Alginate encapsulated BDNF-producing fibroblast grafts permit recovery of function after spinal cord injury in the absence of immune suppression. J Neurotrauma 22:138–156CrossRefPubMed
65.
Xu K, Uchida K, Nakajima H, Kobayashi S, Baba H (2006) Targeted retrograde transfection of adenovirus vector carrying brain-derived neurotrophic factor gene prevents loss of mouse (twy/twy) anterior horn neurons in vivo sustaining mechanical compression. Spine (Phila Pa 1976) 31:1867–1874CrossRef
66.
Holly LT, Blaskiewicz D, Wu A, Feng C, Ying Z, Gomez-Pinilla F (2012) Dietary therapy to promote neuroprotection in chronic spinal cord injury. J Neurosurg Spine 17:134–140CrossRefPubMedCentralPubMed
67.
Ellingson BM, Schmit BD, Gourab K, Sieber-Blum M, Hu YF, Schmainda KM (2009) Diffusion heterogeneity tensor MRI (Alpha-DTI): mathematics and initial applications in spinal cord regeneration after trauma. Biomed Sci Instrum 45:167–172
68.
Nossin-Manor R, Duvdevani R, Cohen Y (2002) q-Space high b value diffusion MRI of hemi-crush in rat spinal cord: evidence for spontaneous regeneration. Magn Reson Imaging 20:231–241CrossRefPubMed
69.
Assaf Y, Mayk A, Eliash S, Speiser Z, Cohen Y (2003) Hypertension and neuronal degeneration in excised rat spinal cord studied by high-b value q-space diffusion magnetic resonance imaging. Exp Neurol 184:726–736CrossRefPubMed
70.
Biton IE, Mayk A, Assaf Y, Cohen Y (2004) Structural changes in glutamate cell swelling followed by multiparametric q-space diffusion MR of excised rat spinal cord. Magn Reson Imaging 22:661–672CrossRefPubMed
71.
Nossin-Manor R, Duvdevani R, Cohen Y (2007) Spatial and temporal damage evolution after hemi-crush injury in rat spinal cord obtained by high b-value q-space diffusion magnetic resonance imaging. J Neurotrauma 24:481–491CrossRefPubMed
72.
73.
Ng MC, Hua J, Hu Y, Luk KD, Lam EY (2009) Magnetization transfer (MT) asymmetry around the water resonance in human cervical spinal cord. J Magn Reson Imaging 29:523–528CrossRefPubMed
74.
Wilhelm MJ, Ong HH, Wehrli SL, Li C, Tsai PH, Hackney DB, Wehrli FW (2012) Direct magnetic resonance detection of myelin and prospects for quantitative imaging of myelin density. Proc Natl Acad Sci USA 109:9605–9610CrossRefPubMedCentralPubMed
75.
Cohen-Adad J, El Mendili MM, Lehericy S, Pradat PF, Blancho S, Rossignol S, Benali H (2011) Demyelination and degeneration in the injured human spinal cord detected with diffusion and magnetization transfer MRI. Neuroimage 55:1024–1033CrossRefPubMed
76.
Metadaten
Titel
Advances in MR imaging for cervical spondylotic myelopathy
verfasst von
Benjamin M. Ellingson
Noriko Salamon
Langston T. Holly
Publikationsdatum
01.04.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe Sonderheft 2/2015
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-013-2915-1

Weitere Artikel der Sonderheft 2/2015

European Spine Journal 2/2015 Zur Ausgabe

Review Article

Predictors of outcome in patients with degenerative cervical spondylotic myelopathy undergoing surgical treatment: results of a systematic review

Original Article

Anterior approaches for cervical spondylotic myelopathy: Which? When? How?

Review Article

Cervical laminectomy and instrumented lateral mass fusion: techniques, pearls and pitfalls

Review article

Laminoplasty and laminectomy for cervical sponydylotic myelopathy: a systematic review

Abstracts

Abstracts for the CSRS-es Annual Meeting in Pamplona 2014

Original Article

Long-term follow-up of clinical and radiological outcome after cervical laminectomy

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

23.04.2024 | Leitsymptom Rückenschmerzen | Nachrichten

Ärztliche Empathie hilft gegen Rückenschmerzen

18.04.2024 | Wirbelsäulenmetastase | Nachrichten

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

16.04.2024 | Spondylitis ankylosans | Nachrichten

Vorsicht mit hohen NSAR-Dosen bei ankylosierender Spondylitis!

15.04.2024 | Knie-TEP | Nachrichten

Brustkrebs in der Vorgeschichte macht Gelenkersatz komplikationsträchtiger
weitere anzeigen

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise