Objective To investigate the applied value of quantitative assessment of the severity of Cervical Spondylotic Myelopathy(CSM)based on the native T1 value of cervical spinal cord T1 mapping.Methods Prospectively,133 patients with CSM(CSM group)and 30 healthy volunteers(control group)were enrolled.Patients with CSM were categorized into a mild group(mJOA ≥12)and a severe group(mJOA＜12)according to the modified Japanese Orthopedic Association scores(mJOA).Axial and sagittal T2WI and sagittal T1 mapping imaging of the cervical spine were performed on all sub-jects,and T1 values were measured at each cervical disc level(C2-C7)in the control group and at the stenotic location,and at the disc level above and below the stenotic location in the patients with CSM(the T1 values at the three levels were counted as T1 stenosis,T1upand T1down).The anteroposterior diameter and cross-sectional area at the stenosis of CSM patients were also measured.The intragroup correlation coefficient(ICC)was used to evaluate the consistency of the measurement results of T,values at each level in the control group by different observers.Univariate analysis was used to compare T,val-ues between cervical segments in the control group,and T,values at the three levels in patients with CSM were also com-pared with the mean T,values in the control group and compared two by two.Univariate analysis was performed to compare the differences in clinical and imaging characteristics and T,values between patients with mild and severe CSM.The mJOA score and each measurement value of CSM patients were correlated.ROC curves were used to determine the differential di-agnostic value of each measurement and the combination of measurements in patients with mild and severe CSM.Results There were 50 cases in the mild CSM group and 83 cases in the severe CSM group.The results of the two observers measur-ing the T,values of the control group at each level were in good agreement(ICC＞0.6),and there was no statistical differ-ence between the T1 values of each level(P＞0.05).The T,up(t=-4.700,P＜0.001),the T1 stenosis(Z=-6.186,P＜0.001),and the T1 down(Z=-4.212,P＜0.001)of the CSM group were statistically different from and higher than the mean T,values of the control group.The T1 stenosis values of the CSM group were statistically different from T1 and T1 down(P＜0.05),and there was no statistically significant difference in the distribution of T1up,and T1down of the CSM group(P＞0.05).The distribution of gender,mJOA,T2(+),T1 stenosis,T1,and T1down between the two groups of patients in the light and heavy groups differed(P＜0.05).The mJOA scores were correlated with anterior and posterior diameters at the steno-sis[r=0.227],vertebral canal cross-sectional area[r=0.209],T2(+)[r=-0.391],T1stenosis[r=-0.678],T1up[r=-0.549],and T1down[r=-0.542]were correlated.The area under the ROC curve(AUC)for patients with anterior and posterior diameter,spinal cross-sectional area,T2(+),T1 stenosis,T1 up and T1 down were 0.575,0.557,0.645,0.857,0.711 and 0.733,respectively.The ROC area under the curve(AUC)of the above T,stenosis in combination with the parame-ters were 0.857,0.860,0.860,0.860,0.859 and 0.859,respectively.Conclusion T1 mapping imaging can quantitative-ly assess the severity of CSM patients and provide reliable imaging parameters for clinical use.
Magnetic resonance imagingCervical Spondylotic MyelopathyT1 mappingquantification
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