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Diffusion tensor imaging observation in Pott's spine with or without neurological deficit

BACKGROUND: Diffusion tensor imaging (DTI) is based upon the phenomenon of water diffusion known as “Brownian motion.” DTI can detect changes in compressed spinal cord earlier than magnetic resonance imaging and is more sensitive to subtle pathological changes of the spinal cord. DTI observation in...

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Autores principales: Abbas, Sohail, Jain, Anil Kumar, Saini, Namita Singh, Kumar, Sudhir, Mukunth, Rajagopalan, Kumar, Jaswant, Kumar, Pawan, Kaur, Prabhjot
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4443410/
https://www.ncbi.nlm.nih.gov/pubmed/26015628
http://dx.doi.org/10.4103/0019-5413.156195
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author Abbas, Sohail
Jain, Anil Kumar
Saini, Namita Singh
Kumar, Sudhir
Mukunth, Rajagopalan
Kumar, Jaswant
Kumar, Pawan
Kaur, Prabhjot
author_facet Abbas, Sohail
Jain, Anil Kumar
Saini, Namita Singh
Kumar, Sudhir
Mukunth, Rajagopalan
Kumar, Jaswant
Kumar, Pawan
Kaur, Prabhjot
author_sort Abbas, Sohail
collection PubMed
description BACKGROUND: Diffusion tensor imaging (DTI) is based upon the phenomenon of water diffusion known as “Brownian motion.” DTI can detect changes in compressed spinal cord earlier than magnetic resonance imaging and is more sensitive to subtle pathological changes of the spinal cord. DTI observation in compressed and noncompressed spinal cord in tuberculosis (TB) spine is not described. This study presents observations in Pott's spine patients with or without neural deficit. MATERIALS AND METHODS: Thirty consecutive cases of TB spine with mean age of 32.1 years of either sexes with paradiscal lesion, with/without paraplegia divided into two groups: Group A: (n = 15) without paraplegia and group B: (n = 15) with paraplegia were evaluated by DTI. The average fractional anisotropy (FA) and mean diffusivity (MD) values were calculated at 3 different sites, above the lesion (SOL)/normal, at the lesion and below SOL for both groups and mean was compared. Visual impression of tractography was done to document changes in spinal tracts. RESULTS: The mean canal encroachment in group A was 39.60% and group B 44.4% (insignificant). Group A mean FA values above SOL, at the lesion and below SOL were 0.608 ± 0.09, 0.554 ± 0.14, and 0.501 ± 0.16 respectively. For group B mean FA values above SOL, at the lesion and below SOL were 0.628 ± 0.09, 0.614 ± 0.12 and 0.487 ± 0.15 respectively. There was a significant difference in mean FA above the SOL as compared to the mean FA at and below SOL. P value above versus below the SOL was statistically significant for both groups (0.04), but P value for at versus below the SOL (0.01) was statistically significant only in group B. On tractography, disruption of fiber tract at SOL was found in 14/15 (93.3%) cases of group A and 14/15 cases (93.3%) of group B (6/6 grade 4, 3/3 grade 3 and 5/6 grade 2 paraplegic cases). CONCLUSION: The FA and MD above the lesion were same as reported for healthy volunteer hence can be taken as control. FA increases, and MD decreases at SOL in severe grade of paraplegia because of epidural collection while in milder grade, both decrease. In group A (without neurological deficit), mean FA and MD in patients with and without canal encroachment was similar. On tractography, both groups A and B (with or without neurological deficit) showed disruption of fiber tract at SOL and thickness of distally traced spinal cord was appreciably less than the upper cord. FA and MD could not differentiate between various grades of paraplegia. Although the number of patients in each group are small.
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spelling pubmed-44434102015-05-26 Diffusion tensor imaging observation in Pott's spine with or without neurological deficit Abbas, Sohail Jain, Anil Kumar Saini, Namita Singh Kumar, Sudhir Mukunth, Rajagopalan Kumar, Jaswant Kumar, Pawan Kaur, Prabhjot Indian J Orthop Original Article BACKGROUND: Diffusion tensor imaging (DTI) is based upon the phenomenon of water diffusion known as “Brownian motion.” DTI can detect changes in compressed spinal cord earlier than magnetic resonance imaging and is more sensitive to subtle pathological changes of the spinal cord. DTI observation in compressed and noncompressed spinal cord in tuberculosis (TB) spine is not described. This study presents observations in Pott's spine patients with or without neural deficit. MATERIALS AND METHODS: Thirty consecutive cases of TB spine with mean age of 32.1 years of either sexes with paradiscal lesion, with/without paraplegia divided into two groups: Group A: (n = 15) without paraplegia and group B: (n = 15) with paraplegia were evaluated by DTI. The average fractional anisotropy (FA) and mean diffusivity (MD) values were calculated at 3 different sites, above the lesion (SOL)/normal, at the lesion and below SOL for both groups and mean was compared. Visual impression of tractography was done to document changes in spinal tracts. RESULTS: The mean canal encroachment in group A was 39.60% and group B 44.4% (insignificant). Group A mean FA values above SOL, at the lesion and below SOL were 0.608 ± 0.09, 0.554 ± 0.14, and 0.501 ± 0.16 respectively. For group B mean FA values above SOL, at the lesion and below SOL were 0.628 ± 0.09, 0.614 ± 0.12 and 0.487 ± 0.15 respectively. There was a significant difference in mean FA above the SOL as compared to the mean FA at and below SOL. P value above versus below the SOL was statistically significant for both groups (0.04), but P value for at versus below the SOL (0.01) was statistically significant only in group B. On tractography, disruption of fiber tract at SOL was found in 14/15 (93.3%) cases of group A and 14/15 cases (93.3%) of group B (6/6 grade 4, 3/3 grade 3 and 5/6 grade 2 paraplegic cases). CONCLUSION: The FA and MD above the lesion were same as reported for healthy volunteer hence can be taken as control. FA increases, and MD decreases at SOL in severe grade of paraplegia because of epidural collection while in milder grade, both decrease. In group A (without neurological deficit), mean FA and MD in patients with and without canal encroachment was similar. On tractography, both groups A and B (with or without neurological deficit) showed disruption of fiber tract at SOL and thickness of distally traced spinal cord was appreciably less than the upper cord. FA and MD could not differentiate between various grades of paraplegia. Although the number of patients in each group are small. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4443410/ /pubmed/26015628 http://dx.doi.org/10.4103/0019-5413.156195 Text en Copyright: © Indian Journal of Orthopaedics http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Abbas, Sohail
Jain, Anil Kumar
Saini, Namita Singh
Kumar, Sudhir
Mukunth, Rajagopalan
Kumar, Jaswant
Kumar, Pawan
Kaur, Prabhjot
Diffusion tensor imaging observation in Pott's spine with or without neurological deficit
title Diffusion tensor imaging observation in Pott's spine with or without neurological deficit
title_full Diffusion tensor imaging observation in Pott's spine with or without neurological deficit
title_fullStr Diffusion tensor imaging observation in Pott's spine with or without neurological deficit
title_full_unstemmed Diffusion tensor imaging observation in Pott's spine with or without neurological deficit
title_short Diffusion tensor imaging observation in Pott's spine with or without neurological deficit
title_sort diffusion tensor imaging observation in pott's spine with or without neurological deficit
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4443410/
https://www.ncbi.nlm.nih.gov/pubmed/26015628
http://dx.doi.org/10.4103/0019-5413.156195
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