Perfusion MRI を用いた変形性頚椎症に対する血流動態の評価

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Evaluation of pre-and postoperative functional status following decompressive surgery of the cervical spine is a challenging issue. Six patients with cervical spondylosis and/or canal stenosis underwent expansive laminoplasty. Perfusion parameters were analyzed with the aid of Principles of Echo-shifting with a Train of Observations (PRESTO) sequence. T2^* decay (dip) was observed in four cases preoperatively and was undetectable preoperatively in two cases. The dip accentuation became prominent postoperatively in all patients except one case. The inability to visualize the dip postoperatively was due to an artifact from the titanium wire fixation used at surgery. Semi-quantitative perfusion parameters (mean transit time; MTT, time of arrival; T0, Time to peak; TTP) were measured and only MTT disclosed the tendency of shortening following operation with significant shortening in one case. The contribution of the venous flow component was suspected to be responsible for the shortening of the MTT since early perfusion component (TTP) showed minimal changes pre-and post-operatively. This is the first study to demonstrate the spinal perfusion method noninvasively using MRI. In conclusion, perfusion study of the cervical spine using PRESTO sequence can be used as an objective evaluation of the functional outcome following cervical decompressive surgery. Further case studies and technical improvement is needed to make this objective semi-quantitative data analysis more reliable.
日本脊髄外科学会の論文
2002-03-31

Perfusion MRI を用いた変形性頚椎症に対する血流動態の評価

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