Cervical compressive myelopathy: flow analysis of cerebrospinal fluid using phase-contrast magnetic resonance imaging.
Eur Spine J
; 26(1): 40-48, 2017 01.
Article
in En
| MEDLINE
| ID: mdl-27858239
ABSTRACT
PURPOSE:
To evaluate cerebrospinal fluid (CSF) flow in cervical compressive myelopathy (CCM), by both quantitative and qualitative analyses, using 3T cine phase-contrast magnetic resonance imaging (cine MRI).METHODS:
From September, 2014 to June, 2015, we enrolled 45 subjects (18 women and 27 men, mean age, 61.7 ± 13.4 years) to undergo cervical cine MRI. The subjects were divided into three groups no stenosis and cervical stenosis with and without intramedullary T2 hyperintensity. We measured maximal CSF velocity, and 12 CSF velocity waveforms were plotted per subject. Two readers independently assessed the CSF waveform shape (0 absent; 1 serrated; 2 bi-directional with small amplitude; and 3 normal bi-directional waveform) and the CSF motion pattern (0 absent; 1 interrupted; and 2 intact). The numbers of 12 waveform shapes were summed to yield a CSF waveform score. Linear mixed model and ROC curve analyses were used for statistical analyses.RESULTS:
Maximal CSF velocity was significantly lower in CCM (marginal mean, 2.72 cm/s) than in stenosis without intramedullary T2 hyperintensity (3.27 cm/s, p = 0.027) and no stenosis (3.80 cm/s, p < 0.001). Bi-phasic CSF motion was lost in cervical stenosis. CSF waveform scores of 17 (area under curve (AUC), 0.797; p = 0.003) and 16.5 (AUC, 0.790; p = 0.004) could predict Japanese Orthopedic Association (JOA) score corresponding to CCM.CONCLUSIONS:
Maximal CSF velocity and CSF waveform score on cine MRI decreased in CCM and was correlated with the JOA score. Thus, both quantitative and qualitative analyses using cine MRI could effectively demonstrate CSF flow alterations in CCM.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Spinal Cord Compression
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Cerebrospinal Fluid
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Cervical Vertebrae
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Magnetic Resonance Imaging, Cine
Type of study:
Observational_studies
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Prognostic_studies
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Qualitative_research
Limits:
Adult
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Aged
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Female
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Humans
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Male
/
Middle aged
Language:
En
Year:
2017
Type:
Article