Risk factors of spinal cord increased signal intensity on T2-weighted magnetic resonance imaging in patients with cervical spondylotic myelopathy

English Keywords:Cervical spondylotic myelopathy  Magnetic resonance imaging  Increased signal intensity  Risk factor

English Abstract:

  【Abstract】 Objectives: To investigate the risk factors affecting the spinal cord increased signal intensity(ISI) on T2-weighted magnetic resonance imaging(MRI) in patients with cervical spondylotic myelopathy(CSM). Methods: From January 2014 to April 2014, 185 patients with CSM in Peking University Third Hospital receiving surgery were included in this study. ISI were classified in three grades: grade 0, no ISI; grade 1, faint and fuzzy border, located in one disc level; grade 2, intense and well-defined border, extending more than one disc level. The degree of spinal compression was measured on the T2-weighted transverse MRI, both segmental and total range of motion(ROM) of cervical spine were measured on the flexion-extension X-Ray. The factors that might affect the progression of ISI were analyzed by single factor analysis first: gender, age, duration of symptoms, preoperative mJOA score, degree of spinal compression, degree of intervertebral disc degeneration, ROM of cervical spine. Then the meaningful factors(P＜0.1) were picked out for ordinal Logistic regression analysis. Results: The incidence of ISI on T2-weighted MRI was 72.4%. According to the grading system: 51 cases in grade 0, accounting for 27.6%; 86 cases in grade 1, accounting for 46.5%; 48 cases in grade 2, accounting for 25.9%. The influence of gender and degree of spinal compression on ISI was statistically significant(female to male′s OR=0.366 and compression ratio′s OR=0.904, respectively, P＜0.05), while there was no significant correlation among age, duration of symptoms, preoperative mJOA score, degree of intervertebral disc degeneration, ROM of cervical spine and ISI(P＞0.05). Conclusions: Male and severe spinal compression were independent risk factors of spinal cord ISI on T2-weighted MRI in patients with CSM.