Diffusion tensor MR fiber tractography in assessment of inflammatory processes and neoplasms of the cervical cord

Abstract

Our goal of this research is to assess the value of MR fiber tractography in assessment of inflammatory process and neoplasms of the cervical cord. Patients: We included 40 patients diagnosed as inflammatory diseases and neoplasm of the cervical cord in our research. 17 patients with pathologically proved cervical cord neoplasms, including three patients with anaplastic astrocytoma, five patients with cellular ependymoma, two patients with anaplastic ependymoma, two patients with fibrillary astrocytoma, one glioblastoma multiforme (GBM), one with cervicomedullary glioma, two with metastasis and one hemangioblastoma. The remaining 23 patients were finally diagnosed as inflammatory processes of the cervical cord, through clinical examination, laboratory results and serial follow up. The latter category include ten patients with myelitis, eight with multiple sclerosis, three patients with post irradiation myelitis and two patients with neuromyelitis optica. Methods: MRI sequences including T2W (sagittal and axial), pre and post contrast T1 (Sagittal and axial) and diffusion tensor MR fiber tractography. Results: All the 17 patients with neoplasm of the cervical cord show more or less displacement of the cervical tract fibers, ten without fibers disruption and seven with fibers disruption. In all patients with inflammatory processes (23 patients) of the cervical cord no fibers displacement identified, but different grades of fibers disruption or sparse fibers. Conclusion: MR fibers tractography is a very promising tool in assessment of inflammatory processes and neoplasms of the cervical cord.

Keywords

• MR tractography
• Cervical cord neoplastic lesions
• Cervical cord neoplastic inflammatory lesions