基于DTI的脊髓型颈椎病患者皮质脊髓束逆行性损害的研究

doi:DOI:10.12117/jccmi.2020.04.003

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Abstract Objective: To observe the characteristics of retrograde Wallerian degeneration of corticospinal tract(CST) in patients with cervical spondylotic myelopathy by diffusion tensor imaging(DTI), and to analyze the relationship between the degree of damage of corticospinal tract and limb motor dysfunction. Materials and Methods: A total of 28 CSM patients and 28 sex-, age- and education-matched healthy controls underwent conventional MRI and DTI examinations. The fractional anisotropy(FA) values and apparent diffusion coefficient(ADC) values of ROI in the bilateral pons, cerebral peduncle, posterior limb of internal capsule, periventricular, centrum semiovale, and subcortical white matter were measured. All subjects were scored for clinical motor function. To analyze the changes of FA and ADC values in each ROI area, and to explore the correlation between these changes and clinical scores. Results: There was no significant difference in FA values and ADC values between the left and right ROI of the CSM group(P>0.05). Compared with the healthy control group, the FA values of the various levels of CSM were reduced(P<0.05), and the ADC values of the centrum semioval, the posterior limb of the internal capsule and the pons were increased(P<0.05). The JOA score of the CSM group was lower than that of the control group(P<0.05), and correlated with the FA values of the pons, cerebral peduncle, posterior limb of internal capsule, and the ADC value of the posterior limb of internal capsule. Conclusion: DTI can detect secondary retrograde Wallerian degeneration of CST in patients with CSM, and this retrograde secondary degeneration of CST is associated with the impairment of motor function.

Key words： Cervical spondylosis Pyramidal tracts Magnetic resonance imaging

Received: 10 June 2019

PACS:	Ｒ681.55
	Ｒ445.2

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	Articles by authors
	ZHAN Ya-ru
	HE Lai-chang
	TAN Yong-ming
	GUO Jian-qiang

Cite this article:

ZHAN Ya-ru,HE Lai-chang,TAN Yong-ming, et al. Study on retrograde degeneration of corticospinal tract in cervical spondylotic myelopathy patients based on DTI[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2020, 31(4): 238-242.

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http://www.jccmi.com.cn/EN/DOI:10.12117/jccmi.2020.04.003 OR http://www.jccmi.com.cn/EN/Y2020/V31/I4/238

[1]Kalsi-Ryan S, Karadimas SK, Fehlings MG. Cervical spondylotic myelopathy: the clinical phenomenon and the current pathobiology of an increasingly prevalent and devastating disorder[J]. Neuroscientist, 2013, 19(4): 409-421. [2]Skelly AC, Hashimoto RE, Norvell DC, et al. Cervical spondylotic myelopathy: methodological approaches to evaluate the literature and establish best evidence[J]. Spine, 2013, 38(1): 9-18. [3]文天林. 不同术式治疗脊髓型颈椎病疗效分析及CSM患者大脑结构重塑的磁共振研究[D]. 中国人民解放军医学院，2016. [4]刘亚东，陈学明，于振山，等. 大鼠脊髓损伤后大脑运动皮质神经元凋亡的观察[J]. 中国脊柱脊髓杂志，2013，23（6）：546-552. [5]Basser PJ, Mattiello J, Lebihan D. MR diffusion tensor spectroscopy and imaging[J]. Biophys J, 1994, 66(1): 259-267. [6]Grabher P, Mohammadi S, David G, et al. Neurodegeneration in the spinal ventral horn prior to motor impairment in cervical spondylotic myelopathy[J]. J Neurotrauma, 2017, 34(15): 2329-2334. [7]李增春，陈德玉，吴德升，等. 第三届全国颈椎病专题座谈会纪要[J]. 中华外科杂志，2008，46（23）：1796-1799. [8]Pierpaoli C, Jezzard P, Basser PJ, et al. Diffusion tensor MR imaging of the human brain[J]. Radiology, 1996, 201(3): 637-648. [9]Jellison BJ, Field AS, Medow J, et al. Diffusion tensor imaging of cerebral white matter: a pictorial review of physics, fiber tract anatomy, and tumor imaging patterns[J]. AJNR, 2004, 25(3): 356-369. [10]Le Bihan MD, Mangin JF, Poupon C, et al. Diffusion tensor imaging: concepts and applications[J]. J Magn Reson Imaging, 2001, 13(4): 534-546. [11]Werring DJ, Toosy AT, Clark CA, et al. Diffusion tensor imaging can detect and quantify corticospinal tract degeneration after stroke[J]. J Neurol Neurosurg Psychiatry, 2000, 69(2): 269-272. [12]Kobayashi S, Hasegawa S, Maki T, et al. Retrograde degeneration of the corticospinal tract associated with pontine infarction[J]. J Neurol Sci, 2005, 236(1): 91-93. [13]Liang Z, Zeng J, Zhang C, et al. Longitudinal investigations on the anterograde and retrograde degeneration in the pyramidal tract following pontine infarction with diffusion tensor imaging[J]. Cerebrovasc Dis, 2008, 25(3): 209-216. [14]Liang Z, Zeng J, Liu S, et al. A prospective study of secondary degeneration following subcortical infarction using diffusion tensor imaging[J]. J Neurol Neurosurg Psychiatry, 2007, 78(6): 581-586. [15]陈峰，刘涛，李建军，等. MRI和MR扩散张量成像在肌萎缩侧索硬化症中的价值[J]. 中国热带医学，2007，7（6）：916-919. [16]Beirowski B, Adalbert R, Wagner D, et al. The progressive nature of Wallerian degeneration in wild-type and slow Wallerian degeneration(WldS) nerves[J]. BMC Neuroscience, 2005, 6: 6. [17]Bronson R, Gilles FH, Hall J, et al. Long term post-traumatic retrograde corticospinal degeneration in man[J]. Hum Pathol, 1978, 9(5): 602-607. [18]Kalil K, Schneider GE. Retrograde cortical and axonal changes following lesions of the pyramidal tract[J]. Brain Res, 1975, 89(1): 15-27. [19]Yamamoto T, Yamasaki M, Imai T. Retrograde pyramidal tract degeneration in a patient with cervical haematomyelia[J]. J Neurol Neurosurg Psychiatry, 1989, 52(3): 382-386. [20]Cui JL, Li X, Chan TY, et al. Quantitative assessment of column-specific degeneration in cervical spondylotic myelopathy based on diffusion tensor tractography[J]. Eur Spine J, 2015, 24(1): 41-47. [21]Jones JG, Cen SY, Lebel RM, et al. Diffusion tensor imaging correlates with the clinical assessment of disease severity in cervical spondylotic myelopathy and predicts outcome following surgery[J]. AJNR, 2013, 34(2): 471-478.