MUSCULOSKELETAL Diffusion tensor imaging and fibre tracking in cervical spondylotic myelopathy Jean-François Budzik & Vincent Balbi & Vianney Le Thuc & Alain Duhamel & Richard Assaker & Anne Cotten Received: 13 April 2010 / Accepted: 28 July 2010 / Published online: 20 August 2010 # European Society of Radiology 2010 Abstract Objectives To (1) obtain microstructural parameters (Fractional Anisotropy: FA, Mean Diffusivity: MD) of the cervical spinal cord in patients suffering from cervical spondylotic myelopathy (CSM) using tractography, (2) to compare DTI parameters with the clinical assessment of these patients (3) and with information issued from conventional sequences. Methods DTI was performed on 20 symptomatic patients with cervical spondylotic myelopathy, matched with 15 volunteers. FA and MD were calculated from tractography images at the C2-C3 level and compressed level in patients and at the C2-C3 and C4-C7 in controls. Patients were clinically evaluated using a self-administered questionnaire. Results The FA values of patients were significantly lower at the compressed level than the FA of volunteers at the C4- C7 level. A significant positive correlation between FA at the compressed level and clinical assessment was demon- strated. Increased signal intensity on T2-weighted images did not correlate either with FA or MD values, or with any of the clinical scores. Conclusion FA values were significantly correlated with some of the patients’ clinical scores. High signal intensity of the spinal cord on T2 was not correlated either with the DTI parameters or with the clinical assessment, suggesting that FA is more sensitive than T2 imaging. Keywords Diffusion tensor imaging . Cervical spondylosis . Tractography . Clinical correlation . Fractional nisotropy Abbreviation DTI Diffusion Tensor Imaging DT Diffusion Tensor CSM Cervical Spondylotic Myelopathy MR Magnetic Resonance FA Fractional Anisotropy MD Mean Diffusivity ADC Apparent Diffusion Coefficient JOACMEQ Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire ROI Region of Interest DTI-FT Fibre Tracking (with Diffusion Tensor Imaging) Introduction Cervical spondylotic myelopathy (CSM) is a common disease caused by chronic segmental compression of the spinal cord due to spondylotic changes. It can lead to severe functional impairment, requiring surgery. MR imaging represents the best imaging technique for the assessment of this disorder.. However, discrepancies between clinical features and signal intensity of the spinal cord on both T1- J.-F. Budzik : V. Balbi : V. Le Thuc : A. Cotten (*) Service de Radiologie et d’Imagerie Musculosquelettique, Hôpital Roger Salengro, 59037 Lille, France e-mail: anne.cotten@chru-lille.fr A. Duhamel Université de Lille, UDSL, EA2694, 59037 Lille, France R. Assaker Département de Neurochirurgie, Hôpital Roger Salengro, 59037 Lille Cedex, France Eur Radiol (2011) 21:426–433 DOI 10.1007/s00330-010-1927-z