Role Of Diffusion Tensor Imaging And Diffusion Tensor Tractography On 3t Mri In Spinal Cord Lesions

Abstract

AIM: The aim of the study is to study the role of Diffusion Tensor Imaging and Diffusion Tensor Tractography on 3T MRI in spinal cord pathologies.

MATERIAL & METHODS: A Prospective observational study includes 50 students at Padmashree Dr. D. Y. Patil Medical College and Hospital and Research Centre, Pimpri, over the period of 2 years in between September 2020 to November 2022. Patients with suspected spinal cord pathologies were subjected to MR Imaging of the spinal cord. Standard spine protocol (Sag T2 tse, Sag T1 tse, Cor T2 stir, Ax T2 tse, Ax T1 tse), DTI and DTT were done for all patients.

RESULTS: Out of 50 participants 23 were females (46%) and 27 were males (54%) & majority of the patient belonged to age group of 31-40 years (26%). 13 patients were normal, and 9 patients had minimal disc bulges but no significant spinal canal stenosis/ indentation of the spinal cord. These 22 patients considered normal showed mean FA (0.69 +/- 0.01) and ADC values (0.88 +/- 0.09) which were similar at all disc levels. In the 15 patients showing significant spinal stenosis and normal appearing cord, statistically significant reduction in FA values and increase in ADC values were seen at levels C3-C4, C4-C5, C5-C6. 2 patients with syrinx, 2 patients with Hirayama disease, and 2 patients with long and short segment cord hyperintensity had significantly reduced FA and increased ADC values. DTT showed displacement of the white matter tracts ventrally in a case of spinomedullary junction astrocytoma.

CONCLUSION: DTI is a promising new tool which offers an insight on the pathophysiology and microstructural changes related to diseases of the spinal cord. DTI changes appear in normal appearing spinal cord in cases of cervical spondylotic myelopathy. This shows promise in detection, prognosticating and planning treatment in some neurosurgical disorders like CSM. More information is needed regarding the precision and dependability of DTI indices in classifying cord disease. To overcome limitations improvement and standardization of scanning procedures and image processing is necessary.