Changes in lumbosacral spinal nerve roots on diffusion tensor imaging in spinal stenosis

Neural Regeneration Research, 2015 · DOI: 10.4103/1673-5374.170317 · Published: November 1, 2015

Neurology Medical Imaging Spinal Disorders

Simple Explanation

This study investigates the use of Diffusion Tensor Imaging (DTI) to assess compressed lumbosacral spinal nerve roots (LSNR) in patients with spinal stenosis. Conventional MRI techniques are limited in imaging the entire LSNR, making DTI a potentially valuable tool for quantitative assessment. The study compares DTI findings with conventional MRI (T1WI and T2WI) in both healthy volunteers and patients with lumbosacral stenosis to evaluate the potential of DTI.

Study Duration

Not specified

Participants

20 healthy volunteers and 93 patients with lumbosacral stenosis

Evidence Level

Not specified

Key Findings

1
DTI showed thinning and distortion in 36 lumbosacral spinal nerve roots (49%) and abruption in 17 lumbosacral spinal nerve roots (23%) in patients with spinal stenosis.
2
Fractional anisotropy (FA) values were reduced in the lumbosacral spinal nerve roots of patients with lumbosacral stenosis, indicating nerve damage.
3
The residual dural sac area of the lumbosacral canal was reduced in patients with lumbosacral stenosis (98.9 ± 25.6 mm2) to two-thirds of the dural sac area of normal persons (115.3 ± 30.7 mm2)

Research Summary

The study assessed the potential of diffusion tensor imaging (DTI) for quantitative assessment of compressed lumbosacral spinal nerve roots in patients with lumbosacral stenosis. DTI findings demonstrated thinning, distortion, and abruption of lumbosacral spinal nerve roots, along with reduced fractional anisotropy values in patients with lumbosacral stenosis. These findings suggest that DTI can objectively and quantitatively evaluate the severity of lumbosacral spinal nerve root compression.

Practical Implications

Improved Diagnostic Accuracy

DTI can provide a more detailed assessment of nerve root compression compared to conventional MRI.

Quantitative Assessment

FA values can serve as an objective measure of nerve damage in spinal stenosis.

Treatment Monitoring

DTI can potentially be used to monitor the effectiveness of treatments for spinal stenosis.

Study Limitations

1
Image distortion can occur with DTI as a result of eddy currents, cerebrospinal fluid motion, and physiological movement
2
The impact of the intervertebral discs should be considered during reconstruction of the LSNR
3
The quality of tractography and spatial resolution of the images were based mainly on the skill and experience of the operator.

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