The Application Of Diffusion Tensor Imaging In The Cervical Muscle Of Cervical Spondyloathy

Part 1 Initial evaluation of Diffusion Tensor Imaging in cervical muscle injury in cervical spondylopathyObjective: To explore the application value of diffusion tensor imaging (DTI) in cervical spondylopathy, and to confirm the effect of cervical muscle in the mechanism of cervical spondylopathy.Methods: We collected 30 controls and 60 patients with cervical spondylopathy, who were performed by magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI).From a series of axially acquired diffusion tensor images and from cervical muscle belly center as region of interest, apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were calculated and compared with healthy and injury cervical muscles. The difference of reconstructing muscle fibers between healthy controls and cervical spondylopathy was observed comparatively.Results: In the ADC value of cervical muscle, left sternocleidomastoid there was significant difference between healthy controls and cervical spondylopathy(P<0.05) ,but in bilateral neck semispinalis, semispinalis capitis,splenius capitis and neck,scalenus and right sternocleidomastoid there was no significant difference between healthy controls and cervical spondylopathy (P >0.05).In the FA value of cervical muscle, right semispinalis capitis,bilateral splenius capitis and neck and right sternocleidomastoid there was significant difference between healthy controls and cervical spondylopathy(P<0.05),but in bilateral neck semispinalis, left semispinalis capitis, left sternocleidomastoid and bilateral scalenus there was no significant difference between healthy controls and cervical spondylopathy (P>0.05). By comparatively observing the same muscle fibers with differences between healthy controls and cervical spondylopathy, the latter were sparser and more disorderly than the former.Conclusion: We can see that the diffusion of the part cervical muscles in cervical spondylopathy is restricted, that is to say, the cervical muscles play a role in the mechanism of cervical spondylopathy whose cervical muscles are injured.Part 2 Initial evaluation of Diffusion Tensor Imaging in cervical muscle in the different types of cervical spondylopathyObjective: To explore the application values of diffusion tensor imaging in the cervical muscle of cervical spondylopathy and to indicate the injury degree of cervical muscle in different types of cervical spondylopathy. Methods: We collected 60 patients with cervical spondylopathy, and to divide them into two groups according to the clinical manifestations of the patients. They were cervical spondylopathy of Neck Type whose main clinical manifestations were headache, neck and shoulder pain, arm pain, neck fatigue and neck rigidity, and MRI features did not include severe cervical disc extrusion and spinal cord involved. The others were cervical spondylopathy of another type. All patients were performed by magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI). From a series of axially acquired diffusion tensor images and from cervical muscle belly center as region of interest, apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were calculated and compared with cervical muscles of both groups. The difference of reconstructing muscle fibers between the Neck type and the other type was observed comparatively.Results: The Neck Type of cervical spondylopathy included 32 patients and the other group included 28.In the ADC value of cervical muscle, bilateral neck semispinalis, semispinalis capitis,splenius capitis and neck, sternocleidomastoid and scalenus there was no significant difference between two types(P>0.05).In the FA value of cervical muscle, left neck semispinalis, bilateral semispinalis capitis, right splenius capitis and neck and right sternocleidomastoid there was significant difference between two types (P<0.05), but in right neck semispinalis, left splenius capitis, left sternocleidomastoid and bilateral scalenus there was no significant difference between two types(P>0.05). By comparatively observing the same muscle fibers with differences between the Neck Type and the other type, the former were more serious injury than the latter.Conclusion: We could see that the fractional anisotropy decreased when the muscles injuried. The injury extents of cervical muscle in different types of cervical spondylopathy are dissimilar. There is damage to the cervical muscle in the early stage of cervical spondylopathy.Part 3 Initial evaluation of Diffusion Tensor Imaging of cervical muscle in various degrees of spinal canal stenosis of cervical spondylopathyObjective: To evaluate the difference of the cervical muscle injury in the various degrees of spinal canal stenosis of cervical spondylopathy by diffusion tensor imaging.Methods: We collected 60 patients with cervical spondylopathy who were performed by magnetic resonance imaging (MRI).According to the MRI features in sagittal T2WI, we divided the spinal canal into three levels of stenosis, that is only compression of the thecal sac (grade I), compression of the thecal sac and spinal cord without spinal cord degeneration (grade II), compression of the thecal sac and spinal cord with spinal cord degeneration (grade III). Then all patients were performed by diffusion tensor imaging (DTI). From a series of axially acquired diffusion tensor images and from cervical muscle belly center as region of interest, apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were calculated and compared with cervical muscles of the three groups.Results: The spinal canal stenosis of cervical spondylopathy included 58 patients,of whom only compression of the thecal sac accounted for 33,compression of the thecal sac and spinal cord without spinal cord degeneration 12, compression of the thecal sac and spinal cord with spinal cord degeneration 13.In comparison with the ADC and FA value of cervical muscle, bilateral neck semispinalis, semispinalis capitis,splenius capitis and neck, sternocleidomastoid and scalenus there was no significant difference in the various degree of spinal canal stenosis (P>0.05).Conclusion: Cervical spinal canal stenosis is the result of long-term evolution of cervical spondylopathy, when the injury of cervical muscle is in chronic phase. We can see that there is no difference in the injury of cervical muscle in the various degrees of spinal canal stenosis of cervical spondylopathy.