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Diffusion-weighted MR Imaging with Apparent Diffusion Coefficient and Apparent Diffusion Tensor Maps in Cervical Spondylotic Myelopathy¹

¹ From the Departments of Neuroradiology (A.D., J.M.C., V.D.), Spinal Orthopedics (J.M.V.), Rheumatology (J.D.), and Functional Neurologic Laboratory (P.A.), CHU-Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux, France; and Department of Magnetic Resonance of Biologic Systems, CNRS/Université Bordeaux, France (M.R., C.T.W.M.). Received May 30, 2002; revision requested July 18; final revision received December 31; accepted February 7, 2003. Address correspondence to V.D. (e-mail: vincent.dousset@chu-bordeaux.fr).

View larger version (144K): [in a new window]   Figure 1a. MR images of the spine in a 52-year-old man with clinical symptoms of myelopathy. (a) Sagittal T2-weighted fast SE image (3,000/120; echo train, 18) shows an area of increased signal intensity (arrow) in the spinal cord at the C6-C7 level. (b) ADC map shows increased ADC values (arrow) at the level of spinal cord compression (C6-C7) and slightly above and below (light gray-white). (c) ADT map shows changes (arrow) in the diffusion direction. Light red indicates increased luminosity corresponding with increased magnitude, and red indicates change of direction to the transverse plane.

View larger version (111K): [in a new window]   Figure 1b. MR images of the spine in a 52-year-old man with clinical symptoms of myelopathy. (a) Sagittal T2-weighted fast SE image (3,000/120; echo train, 18) shows an area of increased signal intensity (arrow) in the spinal cord at the C6-C7 level. (b) ADC map shows increased ADC values (arrow) at the level of spinal cord compression (C6-C7) and slightly above and below (light gray-white). (c) ADT map shows changes (arrow) in the diffusion direction. Light red indicates increased luminosity corresponding with increased magnitude, and red indicates change of direction to the transverse plane.

View larger version (124K): [in a new window]   Figure 1c. MR images of the spine in a 52-year-old man with clinical symptoms of myelopathy. (a) Sagittal T2-weighted fast SE image (3,000/120; echo train, 18) shows an area of increased signal intensity (arrow) in the spinal cord at the C6-C7 level. (b) ADC map shows increased ADC values (arrow) at the level of spinal cord compression (C6-C7) and slightly above and below (light gray-white). (c) ADT map shows changes (arrow) in the diffusion direction. Light red indicates increased luminosity corresponding with increased magnitude, and red indicates change of direction to the transverse plane.

View larger version (114K): [in a new window]   Figure 2a. MR images of the spine in a 50-year-old woman with clinical symptoms of myelopathy confirmed at electrophysiologic examination. (a) Sagittal T2-weighted fast SE image (3,000/120; echo train, 18) shows spinal cord compression at the C5-C6 level but no increase in signal intensity. (b) ADC map shows increased ADC values (arrow) in the spinal cord at C5-C7 (light gray-white). (c) ADT map shows changes (arrow) in the diffusion direction at C5-C7 (blue). This case illustrates the improved detection with diffusion imaging in comparison with T2-weighted imaging.

View larger version (100K): [in a new window]   Figure 2b. MR images of the spine in a 50-year-old woman with clinical symptoms of myelopathy confirmed at electrophysiologic examination. (a) Sagittal T2-weighted fast SE image (3,000/120; echo train, 18) shows spinal cord compression at the C5-C6 level but no increase in signal intensity. (b) ADC map shows increased ADC values (arrow) in the spinal cord at C5-C7 (light gray-white). (c) ADT map shows changes (arrow) in the diffusion direction at C5-C7 (blue). This case illustrates the improved detection with diffusion imaging in comparison with T2-weighted imaging.

View larger version (103K): [in a new window]   Figure 2c. MR images of the spine in a 50-year-old woman with clinical symptoms of myelopathy confirmed at electrophysiologic examination. (a) Sagittal T2-weighted fast SE image (3,000/120; echo train, 18) shows spinal cord compression at the C5-C6 level but no increase in signal intensity. (b) ADC map shows increased ADC values (arrow) in the spinal cord at C5-C7 (light gray-white). (c) ADT map shows changes (arrow) in the diffusion direction at C5-C7 (blue). This case illustrates the improved detection with diffusion imaging in comparison with T2-weighted imaging.

View larger version (119K): [in a new window]   Figure 3a. MR images of the spine in a 40-year-old woman referred for radicular pain who had no clinical symptoms of myelopathy and had negative findings at electrophysiologic examination. (a) Sagittal T2-weighted fast SE image (3,000/120; echo train, 18) shows spinal cord compression (arrow) at the levels of C5-C6 and C6-C7. (b) ADC map shows increased ADC values (arrow) at the level of spinal cord compression and slightly below (light gray-white). (c) ADT map shows changes (arrow) in the diffusion direction (light red).

View larger version (83K): [in a new window]   Figure 3b. MR images of the spine in a 40-year-old woman referred for radicular pain who had no clinical symptoms of myelopathy and had negative findings at electrophysiologic examination. (a) Sagittal T2-weighted fast SE image (3,000/120; echo train, 18) shows spinal cord compression (arrow) at the levels of C5-C6 and C6-C7. (b) ADC map shows increased ADC values (arrow) at the level of spinal cord compression and slightly below (light gray-white). (c) ADT map shows changes (arrow) in the diffusion direction (light red).

View larger version (97K): [in a new window]   Figure 3c. MR images of the spine in a 40-year-old woman referred for radicular pain who had no clinical symptoms of myelopathy and had negative findings at electrophysiologic examination. (a) Sagittal T2-weighted fast SE image (3,000/120; echo train, 18) shows spinal cord compression (arrow) at the levels of C5-C6 and C6-C7. (b) ADC map shows increased ADC values (arrow) at the level of spinal cord compression and slightly below (light gray-white). (c) ADT map shows changes (arrow) in the diffusion direction (light red).