MP2RAGE在退行性颈椎病中的T1定位:一项纵向研究。

IF 2.6 3区 医学 Q2 CLINICAL NEUROLOGY European Spine Journal Pub Date : 2025-01-09 DOI:10.1007/s00586-025-08652-z
Kaissar Farah, Samira Mchinda, Laurianne Pini, Guillaume Baucher, Pierre- Hugues Roche, Stéphane Fuentes, Virginie Callot
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引用次数: 0

摘要

背景和目的:退行性脊髓型颈椎病(DCM)是脊髓功能障碍的最常见原因。在常规临床实践中,常规MRI,尤其是t2加权成像可以很好地描述SC的变化。然而,这种方式通常不能提供令人满意的临床与放射学相关性。在这种情况下,我们评估了T1 MP2RAGE序列测量的定量变化的潜在价值。材料与方法:18例诊断为慢性起病DCM的患者和17例健康对照(HC)纳入研究。临床表现采用改良的日本骨科协会(mJOA)量表进行评估。在基线和术后3个月进行矢状颈椎SC T2-w 3D SPACE成像和T1 MP2RAGE成像。使用Matlab和SC工具箱对数据进行处理。结果:mJOA评分由术前的13.3±2.1分上升至随访时的14.4±1.9分(p = 0.027)。最大压迫部位(Cmax)在C3-C4颈椎水平4例,C4-C5 8例,C5-C6 5例,C6-C7 1例。7例SC受压为多级受压,11例为单级受压。15例患者出现T2-w高信号。DCM组全SC平均T1基线值与HC组(962.2±62 vs 924.9±34 ms)和术后mJOA (R2 = 0.29 (p = 0.024)比较差异有统计学意义(p = 0.013)。随访3个月时C2水平基线T1值与mJOA显著相关(p = 0.048)。结论:DCM患者的T1-MP2RAGE图谱显示局灶性和弥漫性宫颈SC改变。因此,它可能成为手术治疗DCM患者的生物标志物。
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T1 mapping using MP2RAGE in degenerative cervical myelopathy: a longitudinal study.

Background and purpose: Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord (SC) dysfunction. In routine clinical practice, SC changes are well depicted using conventional MRI, especially T2-weighted imaging. However, this modality usually fails to provide satisfactory clinico-radiological correlations. In this context we assessed the potential value of quantitative changes measured with a T1 MP2RAGE sequence.

Materials and methods: 18 patients diagnosed with chronic onset of DCM and 17 healthy controls (HC) were enrolled in the study. Clinical presentation was assessed using the modified Japanese Orthopaedic Association (mJOA) scale. Sagittal cervical SC T2-w 3D SPACE imaging and T1 MP2RAGE mapping were performed at baseline and 3-months postoperatively. Data were processed using Matlab and the SC Toolbox.

Results: mJOA score increased from 13.3 ± 2.1 preoperatively to 14.4 ± 1.9 at follow-up (p = 0.027). Site of maximum compression (Cmax) was at C3-C4 cervical levels in 4 patients, C4-C5 in 8 patients, C5-C6 in 5 patients and C6-C7 in 1 patient. SC compression was multi-level in 7 patients and single-level in 11 patients. T2-w hyperintensity was present in 15 patients. Mean SC T1 values in the whole SC in the DCM group at baseline showed significant difference as compared to mean SC T1 values in HC group (962.2 ± 62 vs. 924.9 ± 34 ms, respectively (p < 0.0001)) but no differences could be observed between baseline and 3-month follow-up (962.4 ± 59 ms (p = 0.86)). Z-scores at baseline were - 0.05 ± 1 for mild, 1.2 ± 1.9 for moderate and 2.5 ± 1.2 for severe. Mean baseline and 3-month follow-up SC T1 values were weakly but significantly correlated to preoperative (R2 = 0.33 (p = 0.013) and postoperative mJOA (R2 = 0.29 (p = 0.024). Baseline T1 value at C2 level was significantly correlated with mJOA at 3-month follow-up (p = 0.048).

Conclusions: T1-MP2RAGE mapping in patients with DCM demonstrated both focal and diffuse cervical SC alteration. It could thus be a biomarker for patients with DCM managed surgically.

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来源期刊
European Spine Journal
European Spine Journal 医学-临床神经学
CiteScore
4.80
自引率
10.70%
发文量
373
审稿时长
2-4 weeks
期刊介绍: "European Spine Journal" is a publication founded in response to the increasing trend toward specialization in spinal surgery and spinal pathology in general. The Journal is devoted to all spine related disciplines, including functional and surgical anatomy of the spine, biomechanics and pathophysiology, diagnostic procedures, and neurology, surgery and outcomes. The aim of "European Spine Journal" is to support the further development of highly innovative spine treatments including but not restricted to surgery and to provide an integrated and balanced view of diagnostic, research and treatment procedures as well as outcomes that will enhance effective collaboration among specialists worldwide. The “European Spine Journal” also participates in education by means of videos, interactive meetings and the endorsement of educative efforts. Official publication of EUROSPINE, The Spine Society of Europe
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