Diffusion Tensor Imaging and Fiber Tractography Reveal Significant Microstructural Changes of Cervical Nerve Roots in Patients with Cervical Spondylotic Radiculopathy.

Abstract

To delineate the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of patients with cervical spondylotic radiculopathy by diffusion tensor imaging and fiber bundle tracing. Thirty patients with cervical spondylotic radiculopathy and 24 healthy volunteers were assessed using the International Standards for Neurological Classification of Spinal Cord Injury scale. All subjects underwent conventional sagittal T1- and T2-weighted imaging and horizontal 3-dimensional T2 driven equilibrium radiofrequency reset pulse and diffusion tensor imaging scan. The ADC and FA values were measured in the cervical nerve at most stenotic segment and heterolateral nonstenotic segment of patients. Fiber tractography revealed thinned and sparse nerve roots and disruption of the fiber bundles in patients with cervical spondylotic radiculopathy. The FA values of C5-C8 in healthy volunteers or heterolateral nonstenotic nerve of patients with cervical spondylotic radiculopathy were significantly greater than those of the stenotic cervical segments of patients with cervical spondylotic radiculopathy (both P < 0.01). Furthermore, the ADC values of C5-C8 in healthy volunteers or heterolateral nonstenotic nerve of patients with cervical spondylotic radiculopathy were significantly lower than those of the stenotic cervical segments of cervical spondylotic radiculopathy patients (both P < 0.01). Fiber tractography is capable of delineating microstructural changes of cervical nerve roots and cervical spondylotic radiculopathy exhibits significant changes in FA and ADC values.