| ObjectiveThe fractional anisotropy（FA）and apparent diffusion coefficient（ADC）values of compressed spinal cord and nerve roots in patients with cervical spondylosis（CS）were quantitatively measured by magnetic resonance diffusion tensor imaging（DTI）,and fiber bundles were visualized by diffusion tensor tractography（DTT）,to explore the correlation between FA and ADC values and clinical evaluation and clinical value in evaluating the severity of CS.MethodsThe study included 67 patients diagnosed with CS by magnetic resonance imaging（MRI）in the Central Hospital affiliated to Shenyang Medical College from December2020 to August 2021,and 30 healthy volunteers were recruited.All participants received conventional MRI and DTI examination.Patients with CS were scored according to the modified Japanese Orthopaedic Association（m JOA）score.According to the diagnosis results of conventional sagittal MRI and clinical manifestations of patients,the most severely compressed spinal cord segments and cervical nerve roots were selected,and regions of interest（ROIs）with the same size（about 2-4 pixels）were selected from FA and ADC maps to measure FA and ADC values.FA and ADC values were measured from cervical spinal cord and bilateral cervical nerve roots corresponding to C3-7 discs in healthy volunteers.The average value is determined after three measurements as the final measurement result.Shapiro-Wilk test was used to test the normality of the data,and the measurement data were expressed as mean±standard deviation（（?）±s）.One-way ANOVA was used to compare the DTI parameters of healthy volunteers in different age groups.The matched sample t test was used to compare the DTI parameters of bilateral nerve roots at the same level.DTI parameters were compared between healthy volunteers and patients using independent sample t test.Pearson correlation analysis was used to analyze the correlation between FA,ADC and m JOA score in spinal cord and nerve root with the most severe compression in patients with CS.The receiver operating characteristic（ROC）curve was analyzed to obtain the optimal diagnostic threshold,area under the curve（AUC）,sensitivity and specificity of FA and ADC values of CS of different severity.P<0.05 was statistically significant.Results1.The comparison of FA and ADC values between patients with CS and healthy volunteers showed that FA values of spinal cord and nerve roots in patients with CS were significantly lower than those of healthy volunteers,while ADC values were significantly higher than those of healthy volunteers,with statistically significant differences（P<0.05）.2.Pearson correlation analysis results showed that FA value of spinal cord and nerve root in patients with CS was positively correlated with m JOA score,while ADC value was negatively correlated with m JOA score.FA and ADC value were not correlated with m JOA score in C3/4 segment of spinal cord in patients with CS,which may be due to the small sample size.3.ROC curve analysis results showed that the FA value AUC of mild CS was0.759-0.839,the ADC value AUC was 0.743-0.850.The FAAUC of moderate CS were0.793-0.963,the ADC value AUC was 0.757-0.933.The FA value AUC of severe CS was 0.956-0.952,the ADC value AUC was 0.848-1.000.Conclusions1.Spinal cord or nerve root compression in patients with CS will result in changes in DTI parameters,with lower FA values and higher ADC values compared with healthy volunteers.2.DTI parameters（FA and ADC values）were correlated with the severity of patients with CS（m JOA score）,which had important clinical significance for the severity assessment of patients with CS.3.DTT can visualize the nerve fiber bundle,and can clearly and intuitively observe the subtle structural changes of compresseed spinal cord and nerve root in patients with CS.DTI parameters（FA and ADC values）can quantitatively evaluate the severity of the CS,and can detect the progression of CS early,which has certain reference value for clinical diagnosis and treatment. |
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