Role of Diffusion Tensor Imaging in Early Detection of Cervical Spondylotic Myelopathy: An Observational Study

Introduction: Cervical Spondylotic Myelopathy (CSM) is a common degenerative spinal condition that can lead to significant neurological deficits if not detected early. Conventional Magnetic Resonance Imaging (MRI), while useful, has limited sensitivity in detecting early myelopathic changes. Diffusi...

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Main Authors: Bhumika Dinesh Maheshwari, Jeffrey Skaria Joseph, Ealai athmarao Parthasarathy, KP Khavin Kumar, Sathyanarayanan Venkatesan
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2025-04-01
Series:Journal of Clinical and Diagnostic Research
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Online Access:https://jcdr.net/articles/PDF/20847/78245_CE[Ra1]__F(SL)_PF1(AB_SL)_PFA(IS)_PB(Pr_IS)_PN(IS).pdf
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author Bhumika Dinesh Maheshwari
Jeffrey Skaria Joseph
Ealai athmarao Parthasarathy
KP Khavin Kumar
Sathyanarayanan Venkatesan
author_facet Bhumika Dinesh Maheshwari
Jeffrey Skaria Joseph
Ealai athmarao Parthasarathy
KP Khavin Kumar
Sathyanarayanan Venkatesan
author_sort Bhumika Dinesh Maheshwari
collection DOAJ
description Introduction: Cervical Spondylotic Myelopathy (CSM) is a common degenerative spinal condition that can lead to significant neurological deficits if not detected early. Conventional Magnetic Resonance Imaging (MRI), while useful, has limited sensitivity in detecting early myelopathic changes. Diffusion Tensor Imaging (DTI), a novel MRI technique, offers quantitative parameters such as Fractional Anisotropy (FA) and Apparent Diffusion Coefficient (ADC), which may aid in the early detection and severity assessment of CSM. Aim: To estimate and compare DTI parameters (FA and ADC) at stenotic and non stenotic levels in patients with CSM and to correlate these parameters with clinical severity using the modified Japanese Orthopaedic Association (mJOA) score. Materials and Methods: An observational study was conducted at a Chettinad hospital and research institute involving 30 patients with CSM. Ethical clearance and informed consent were obtained. Patients underwent conventional MRI and DTI sequences using a 3T Philips MRI scanner. The FA and ADC values were measured at stenotic and non stenotic levels. Clinical severity was assessed using the mJOA score. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 27, with paired sample t-tests and Pearson’s correlation (p<0.05 considered significant). Results: The mean FA value was significantly lower at stenotic levels (0.46) compared to non stenotic levels (0.61) (p=0.001). Conversely, the mean ADC value was significantly higher at stenotic levels (1.35) compared to non stenotic levels (1.02) (p=0.001). A strong positive correlation was observed between FA values at stenotic levels and mJOA scores (r=0.946, p=0.001), while a strong negative correlation was found between ADC values and mJOA scores (r=-0.920, p=0.001). Conclusion: DTI parameters (FA and ADC) demonstrated significant changes at stenotic levels in CSM patients and correlated strongly with clinical severity. DTI holds promise as a quantitative tool for early detection and severity assessment of CSM.
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spelling doaj-art-ee76d9a4c2af49e38a2bac2b709823212025-08-20T02:16:33ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2025-04-01194010510.7860/JCDR/2025/78245.20847Role of Diffusion Tensor Imaging in Early Detection of Cervical Spondylotic Myelopathy: An Observational StudyBhumika Dinesh Maheshwari0Jeffrey Skaria Joseph1Ealai athmarao Parthasarathy2KP Khavin Kumar3Sathyanarayanan Venkatesan4Junior Resident, Department of Radiology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Chennai, Tamil Nadu, India.Assistant Professor, Department of Radiology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Chennai, Tamil Nadu, India.Professor, Department of Radiology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Chennai, Tamil Nadu, India.Junior Resident, Department of Radiology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Chennai, Tamil Nadu, India.Senior Resident, Department of Radiology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Chennai, Tamil Nadu, India.Introduction: Cervical Spondylotic Myelopathy (CSM) is a common degenerative spinal condition that can lead to significant neurological deficits if not detected early. Conventional Magnetic Resonance Imaging (MRI), while useful, has limited sensitivity in detecting early myelopathic changes. Diffusion Tensor Imaging (DTI), a novel MRI technique, offers quantitative parameters such as Fractional Anisotropy (FA) and Apparent Diffusion Coefficient (ADC), which may aid in the early detection and severity assessment of CSM. Aim: To estimate and compare DTI parameters (FA and ADC) at stenotic and non stenotic levels in patients with CSM and to correlate these parameters with clinical severity using the modified Japanese Orthopaedic Association (mJOA) score. Materials and Methods: An observational study was conducted at a Chettinad hospital and research institute involving 30 patients with CSM. Ethical clearance and informed consent were obtained. Patients underwent conventional MRI and DTI sequences using a 3T Philips MRI scanner. The FA and ADC values were measured at stenotic and non stenotic levels. Clinical severity was assessed using the mJOA score. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 27, with paired sample t-tests and Pearson’s correlation (p<0.05 considered significant). Results: The mean FA value was significantly lower at stenotic levels (0.46) compared to non stenotic levels (0.61) (p=0.001). Conversely, the mean ADC value was significantly higher at stenotic levels (1.35) compared to non stenotic levels (1.02) (p=0.001). A strong positive correlation was observed between FA values at stenotic levels and mJOA scores (r=0.946, p=0.001), while a strong negative correlation was found between ADC values and mJOA scores (r=-0.920, p=0.001). Conclusion: DTI parameters (FA and ADC) demonstrated significant changes at stenotic levels in CSM patients and correlated strongly with clinical severity. DTI holds promise as a quantitative tool for early detection and severity assessment of CSM.https://jcdr.net/articles/PDF/20847/78245_CE[Ra1]__F(SL)_PF1(AB_SL)_PFA(IS)_PB(Pr_IS)_PN(IS).pdfapparent diffusion coefficientfractional anisotropyneuroimagingspinal cord compression
spellingShingle Bhumika Dinesh Maheshwari
Jeffrey Skaria Joseph
Ealai athmarao Parthasarathy
KP Khavin Kumar
Sathyanarayanan Venkatesan
Role of Diffusion Tensor Imaging in Early Detection of Cervical Spondylotic Myelopathy: An Observational Study
Journal of Clinical and Diagnostic Research
apparent diffusion coefficient
fractional anisotropy
neuroimaging
spinal cord compression
title Role of Diffusion Tensor Imaging in Early Detection of Cervical Spondylotic Myelopathy: An Observational Study
title_full Role of Diffusion Tensor Imaging in Early Detection of Cervical Spondylotic Myelopathy: An Observational Study
title_fullStr Role of Diffusion Tensor Imaging in Early Detection of Cervical Spondylotic Myelopathy: An Observational Study
title_full_unstemmed Role of Diffusion Tensor Imaging in Early Detection of Cervical Spondylotic Myelopathy: An Observational Study
title_short Role of Diffusion Tensor Imaging in Early Detection of Cervical Spondylotic Myelopathy: An Observational Study
title_sort role of diffusion tensor imaging in early detection of cervical spondylotic myelopathy an observational study
topic apparent diffusion coefficient
fractional anisotropy
neuroimaging
spinal cord compression
url https://jcdr.net/articles/PDF/20847/78245_CE[Ra1]__F(SL)_PF1(AB_SL)_PFA(IS)_PB(Pr_IS)_PN(IS).pdf
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