Korean Journal of Radiology

  • 제22권7호
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  • Pages.1163-1171
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  • 2021
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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Intensity of Intraoperative Spinal Cord Hyperechogenicity as a Novel Potential Predictive Indicator of Neurological Recovery for Degenerative Cervical Myelopathy

  • Guoliang Chen (Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology/Orthopaedic Research Institute, Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-sen University) ;
  • Fuxin Wei (Department of Orthopedic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University) ;
  • Jiachun Li (Department of Orthopedic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University) ;
  • Liangyu Shi (Department of Orthopedic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University) ;
  • Wei Zhang (Department of Orthopedic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University) ;
  • Xianxiang Wang (Department of Ultrasound, The Seventh Affiliated Hospital, Sun Yat-sen University) ;
  • Zuofeng Xu (Department of Ultrasound, The Seventh Affiliated Hospital, Sun Yat-sen University) ;
  • Xizhe Liu (Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology/Orthopaedic Research Institute, Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-sen University) ;
  • Xuenong Zou (Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology/Orthopaedic Research Institute, Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-sen University) ;
  • Shaoyu Liu (Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology/Orthopaedic Research Institute, Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-sen University)
  • 투고 : 2020.06.11
  • 심사 : 2020.11.03
  • 발행 : 2021.07.01
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초록

Objective: To analyze the correlations between intraoperative ultrasound and MRI metrics of the spinal cord in degenerative cervical myelopathy and identify novel potential predictive ultrasonic indicators of neurological recovery for degenerative cervical myelopathy. Materials and Methods: Twenty-two patients who underwent French-door laminoplasty for multilevel degenerative cervical myelopathy were followed up for 12 months. The Japanese Orthopedic Association (JOA) scores were assessed preoperatively and 12 months postoperatively. Maximum spinal cord compression and compression rates were measured and calculated using both intraoperative ultrasound imaging and preoperative T2-weight (T2W) MRI. Signal change rates of the spinal cord on preoperative T2W MRI and gray value ratios of dorsal and ventral spinal cord hyperechogenicity on intraoperative ultrasound imaging were measured and calculated. Correlations between intraoperative ultrasound metrics, MRI metrics, and the recovery rate JOA scores were analyzed using Spearman correlation analysis. Results: The postoperative JOA scores improved significantly, with a mean recovery rate of 65.0 ± 20.3% (p < 0.001). No significant correlations were found between the operative ultrasound metrics and MRI metrics. The gray value ratios of the spinal cord hyperechogenicity was negatively correlated with the recovery rate of JOA scores (ρ = -0.638, p = 0.001), while the ventral and dorsal gray value ratios of spinal cord hyperechogenicity were negatively correlated with the recovery rate of JOA-motor scores (ρ = -0.582, p = 0.004) and JOA-sensory scores (ρ = -0.452, p = 0.035), respectively. The dorsal gray value ratio was significantly higher than the ventral gray value ratio (p < 0.001), while the recovery rate of JOA-motor scores was better than that of JOA-sensory scores at 12 months post-surgery (p = 0.028). Conclusion: For degenerative cervical myelopathy, the correlations between intraoperative ultrasound and preoperative T2W MRI metrics were not significant. Gray value ratios of the spinal cord hyperechogenicity and dorsal and ventral spinal cord hyperechogenicity were significantly correlated with neurological recovery at 12 months postoperatively.

키워드

과제정보

This study was supported by the R&D Program of Guangzhou City (No.201807010031, No.201704030082), the Sanming Project of Medicine in Shenzhen (No. SZSM201911002) and the Sun Yat-sen University Clinical Research 5010 Program (No. 2019009).

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