切换至 "中华医学电子期刊资源库"

中华脑科疾病与康复杂志(电子版) ›› 2021, Vol. 11 ›› Issue (06) : 331 -335. doi: 10.3877/cma.j.issn.2095-123X.2021.06.003

临床研究

扩散张量成像对脊髓型颈椎病预测价值的Meta分析
冯妍1, 范雁东1, 吴金泽1, 芒苏尔·努尔麦麦提1, 排日哈提·居麦1, 罗坤1,()   
  1. 1. 830011 乌鲁木齐,新疆医科大学第一附属医院神经外科中心
  • 收稿日期:2021-10-16 出版日期:2021-12-15
  • 通信作者: 罗坤
  • 基金资助:
    新疆维吾尔自治区自然科学基金(2019D01C323)

Meta-analysis of the predictive value of diffusion tensor imaging in cervical spondylotic myelopathy

Yan Feng1, Yandong Fan1, Jinze Wu1, Nuermaimaiti Mangsuer·1, Jumai Pairihati·1, Kun Luo1,()   

  1. 1. Department of Neurosurgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, China
  • Received:2021-10-16 Published:2021-12-15
  • Corresponding author: Kun Luo
引用本文:

冯妍, 范雁东, 吴金泽, 芒苏尔·努尔麦麦提, 排日哈提·居麦, 罗坤. 扩散张量成像对脊髓型颈椎病预测价值的Meta分析[J]. 中华脑科疾病与康复杂志(电子版), 2021, 11(06): 331-335.

Yan Feng, Yandong Fan, Jinze Wu, Nuermaimaiti Mangsuer·, Jumai Pairihati·, Kun Luo. Meta-analysis of the predictive value of diffusion tensor imaging in cervical spondylotic myelopathy[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2021, 11(06): 331-335.

目的

系统评价扩散张量成像(DTI)常用变量各向异性参数(FA)和表观扩散系数(ADC)对脊髓型颈椎病(CSM)的预测价值。

方法

在PubMed、Cochrane Library、EMBASE、Web of Science和万方数据库中检索2000~2021年CSM患者与健康对照者的DTI队列研究,采用改良纽卡斯尔-渥太华量表(NOS)对纳入文献进行质量评估,采用STATA14.0软件进行连续性变量资料的Meta分析。

结果

最终纳入10篇文献,共有327例CSM患者和208名健康对照者,在FA值的比较中,CSM患者组282例,健康对照组199例,CSM患者中最大受压水平(LMC)比健康对照组的FA低,差异具有统计学意义(SMD=-2.32,95%CI:-2.56~-2.06,P<0.001);在ADC值的比较中,CSM患者组177例,健康对照组132例,CSM患者组中LMC比健康对照组的ADC高,差异具有统计学意义(SMD=1.95,95%CI:1.67~2.23,P<0.001)。

结论

作为DTI参数的FA值和ADC值具有成为预测CSM的潜在能力,DTI有很大的可能成为诊断CSM的一个重要组成部分。

Objective

To systematically evaluate the predictive value of the anisotropy parameter (FA) and the apparent diffusion coefficient (ADC) of the common variables of diffusion tensor imaging (DTI) for cervical spondylotic myelopathy (CSM).

Methods

DTI cohort studies of CSM patients and healthy controls were retrieved from PubMed, Cochrane Library, Embase, Web of Science and Wanfang database from 2000 to 2021. The modified Newcastle-Ottawa scale (NOS) was used to evaluate the quality of the included literature. The Meta-analysis of continuous variable data was performed using Stata 14.0 software.

Results

A total of 10 studies were included, including 327 patients with CSM and 208 healthy controls. In the comparison of FA values, there were 282 patients in the CSM group and 199 healthy controls. The Level of maximal cord compression LMC in CSM patients was lower than that in healthy controls, and the results were statistically significant (SMD=-2.32, 95%CI: -2.56--2.06, P<0.001). In the comparison of ADC values, there were 177 patients in the CSM group and 132 in the healthy control group. The LMC in the CSM group was higher than that in the healthy control group, and the results were statistically significant (SMD=1.95, 95%CI: 1.67-2.23, P<0.001).

Conclusion

As DTI parameters, FA value and ADC value have potential ability to predict CSM, and DTI may be an important part in the diagnosis of CSM.

图1 文献检索流程图
表1 纳入研究的基本特征
表2 所纳入研究质量评估
图2 脊髓型颈椎病患者与健康对照组各向异性参数值比较的森林图
图3 脊髓型颈椎病患者与健康对照组表观扩散系数值比较的森林图
图4 脊髓型颈椎病患者与健康对照组各向异性参数值漏斗图
图5 脊髓型颈椎病患者与健康对照组表观扩散系数值漏斗图
[1]
Smith ZA, Khayatzadeh S, Bakhsheshian J, et al. Dimensions of the cervical neural foramen in conditions of spinal deformity: an ex vivo biomechanical investigation using specimen-specific CT imaging[J]. Eur Spine J, 2016, 25(7): 2155-2165.
[2]
Kara B, Celik A, Karadereler S, et al. The role of DTI in early detection of cervical spondylotic myelopathy: a preliminary study with 3-T MRI[J]. Neuroradiology, 2011, 53(8): 609-616.
[3]
Demir A, Ries M, Moonen CT, et al. Diffusion-weighted MR imaging with apparent diffusion coefficient and apparent diffusion tensor maps in cervical spondylotic myelopathy[J]. Radiology, 2003, 229(1): 37-43.
[4]
Vedantam A, Jonathan A, Rajshekhar V. Association of magnetic resonance imaging signal changes and outcome prediction after surgery for cervical spondylotic myelopathy[J]. J Neurosurg Spine, 2011, 15(6): 660-666.
[5]
Ellingson BM, Salamon N, Holly LT. Advances in MR imaging for cervical spondylotic myelopathy[J]. Eur Spine J, 2015, 24 Suppl 2(Suppl 2): 197-208.
[6]
Banaszek A, Bladowska J, Podgórski P, et al. Role of diffusion tensor MR imaging in degenerative cervical spine disease: a review of the literature[J]. Clin Neuroradiol, 2016, 26(3): 265-276.
[7]
Wang K, Chen Z, Zhang F, et al. Evaluation of DTI parameter ratios and diffusion tensor tractography grading in the diagnosis and prognosis prediction of cervical spondylotic myelopathy[J]. Spine (Phila Pa 1976), 2017, 42(4): E202-E210.
[8]
Jiang W, Han X, Guo H, et al. Usefulness of conventional magnetic resonance imaging, diffusion tensor imaging and neurite orientation dispersion and density imaging in evaluating postoperative function in patients with cervical spondylotic myelopathy[J]. J Orthop Translat, 2018, 15: 59-69.
[9]
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.
[10]
Chen X, Kong C, Feng S, et al. Magnetic resonance diffusion tensor imaging of cervical spinal cord and lumbosacral enlargement in patients with cervical spondylotic myelopathy[J]. J Magn Reson Imaging, 2016, 43(6): 1484-1491.
[11]
Toktas ZO, Tanrıkulu B, Koban O, et al. Diffusion tensor imaging of cervical spinal cord: a quantitative diagnostic tool in cervical spondylotic myelopathy[J]. J Craniovertebr Junction Spine, 2016, 7(1): 26-30.
[12]
Ying J, Zhou X, Zhu M, et al. The contribution of diffusion tensor imaging to quantitative assessment on multilevel cervical spondylotic myelopathy[J]. Eur Neurol, 2016, 75(1-2): 67-74.
[13]
Liu Y, Kong C, Cui L, et al. Correlation between diffusion tensor imaging parameters and clinical assessments in patients with cervical spondylotic myelopathy with and without high signal intensity[J]. Spinal Cord, 2017, 55(12): 1079-1083.
[14]
Rao A, Soliman H, Kaushal M, et al. Diffusion tensor imaging in a large longitudinal series of patients with cervical spondylotic myelopathy correlated with long-term functional outcome[J]. Neurosurgery, 2018, 83(4): 753-760.
[15]
Iwasaki M, Yokohama T, Oura D, et al. Decreased value of highly accurate fractional anisotropy using 3-Tesla ZOOM diffusion tensor imaging after decompressive surgery in patients with cervical spondylotic myelopathy: aligned fibers effect[J]. World Neurosurg X, 2019, 4: 100056.
[16]
Han X, Ma X, Li D, et al. The evaluation and prediction of laminoplasty surgery outcome in patients with degenerative cervical myelopathy using diffusion tensor MRI[J]. AJNR Am J Neuroradiol, 2020, 41(9): 1745-1753.
[17]
Wu W, Yang Z, Zhang T, et al. Microstructural changes in compressed cervical spinal cord are consistent with clinical symptoms and symptom duration[J]. Spine (Phila Pa 1976), 2020, 45(16): E999-E1005.
[18]
Ulubaba HE, Saglik S, Yildirim IO, et al. Effectiveness of diffusion tensor imaging in determining cervical spondylotic myelopathy[J]. Turk Neurosurg, 2021, 31(1): 67-72.
[19]
Vedantam A, Rao A, Kurpad SN, et al. Diffusion tensor imaging correlates with short-term myelopathy outcome in patients with cervical spondylotic myelopathy[J]. World Neurosurg, 2017, 97: 489-494.
[20]
Facon D, Ozanne A, Fillard P, et al. MR diffusion tensor imaging and fiber tracking in spinal cord compression[J]. AJNR Am J Neuroradiol, 2005, 26(6): 1587-1594.
[21]
Rajasekaran S, Yerramshetty JS, Chittode VS, et al. The assessment of neuronal status in normal and cervical spondylotic myelopathy using diffusion tensor imaging[J]. Spine (Phila Pa 1976), 2014, 39(15): 1183-1189.
[22]
Rajasekaran S, Prasad V, Shetty J, et al. Diffusion tensor imaging as a prognostic investigation in cervical myelopathy-comparison of pre- and postsurgical decompression DTI indices and tractography in 56 subjects[J]. Global Spine J, 2012, 2(1-suppl): 137-157.
[23]
Mamata H, Jolesz FA, Maier SE. Apparent diffusion coefficient and fractional anisotropy in spinal cord: age and cervical spondylosis-related changes[J]. J Magn Reson Imaging, 2005, 22(1): 38-43.
[24]
Wang SQ, Li X, Cui JL, et al. Prediction of myelopathic level in cervical spondylotic myelopathy using diffusion tensor imaging[J]. J Magn Reson Imaging, 2015, 41(6): 1682-1688.
[1] 张思平, 刘伟, 马鹏程. 全膝关节置换术后下肢轻度内翻对线对疗效的影响[J]. 中华关节外科杂志(电子版), 2023, 17(06): 808-817.
[2] 罗旺林, 杨传军, 许国星, 俞建国, 孙伟东, 颜文娟, 冯志. 开放性楔形胫骨高位截骨术不同植入材料的Meta分析[J]. 中华关节外科杂志(电子版), 2023, 17(06): 818-826.
[3] 马鹏程, 刘伟, 张思平. 股骨髋臼撞击综合征关节镜手术中闭合关节囊的疗效影响[J]. 中华关节外科杂志(电子版), 2023, 17(05): 653-662.
[4] 陈宏兴, 张立军, 张勇, 李虎, 周驰, 凡一诺. 膝骨关节炎关节镜清理术后中药外用疗效的Meta分析[J]. 中华关节外科杂志(电子版), 2023, 17(05): 663-672.
[5] 邢阳, 何爱珊, 康焱, 杨子波, 孟繁钢, 邬培慧. 前交叉韧带单束联合前外侧结构重建的Meta分析[J]. 中华关节外科杂志(电子版), 2023, 17(04): 508-519.
[6] 李雄雄, 周灿, 徐婷, 任予, 尚进. 初诊导管原位癌伴微浸润腋窝淋巴结转移率的Meta分析[J]. 中华普通外科学文献(电子版), 2023, 17(06): 466-474.
[7] 张再博, 王冰雨, 焦志凯, 檀碧波. 胃癌术后下肢深静脉血栓危险因素的Meta分析[J]. 中华普通外科学文献(电子版), 2023, 17(06): 475-480.
[8] 武慧铭, 郭仁凯, 李辉宇. 机器人辅助下经自然腔道取标本手术治疗结直肠癌安全性和有效性的Meta分析[J]. 中华普通外科学文献(电子版), 2023, 17(05): 395-400.
[9] 莫闲, 杨闯. 肝硬化患者并发门静脉血栓危险因素的Meta分析[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 678-683.
[10] 刘佳铭, 孙晓容, 文健, 何晓丽, 任茂玲. 有氧运动对成人哮喘肺功能、生活质量以及哮喘控制影响的Meta分析[J]. 中华肺部疾病杂志(电子版), 2023, 16(04): 592-595.
[11] 段文忠, 白延霞, 徐文亭, 祁虹霞, 吕志坚. 七氟烷和丙泊酚在肝切除术中麻醉效果比较Meta分析[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 640-645.
[12] 杨海龙, 邓满军, 樊羿辰, 徐梦钰, 陈芳德, 吴威浩, 张生元. 腹腔镜胆总管探查术一期缝合术后胆漏危险因素Meta分析[J]. 中华肝脏外科手术学电子杂志, 2023, 12(05): 545-550.
[13] 阿依别克·吐尔得汉, 陈伦牮, 巴合体·卡力甫, 陈雄, 梦塬. 血清免疫抗原在包虫病诊断中的价值Meta分析[J]. 中华肝脏外科手术学电子杂志, 2023, 12(03): 300-304.
[14] 徐红莉, 杨钰琳, 薛清, 张茜, 马丽虹, 邱振刚. 体外冲击波治疗非特异性腰痛疗效的系统评价和Meta分析[J]. 中华老年骨科与康复电子杂志, 2023, 09(05): 307-314.
[15] 耿磊, 张照婷, 许磊, 黄海, 孙毅, 杨伏猛, 徐凯, 胡春峰. 帕金森病前驱期基底神经节环路磁共振弥散张量成像的应用研究[J]. 中华临床医师杂志(电子版), 2023, 17(9): 995-1003.
阅读次数
全文


摘要