T1 mapping in patients with cervical spinal canal stenosis with and without decompressive surgery: A longitudinal study

Abstract

AbstractBackground and PurposeCervical spinal canal stenosis (cSCS) is a common cause of spinal impairment in the elderly. With conventional magnetic resonance imaging (MRI) suffering from various limitations, high‐resolution single‐shot T1 mapping has been proposed as a novel MRI technique in cSCS diagnosis. In this study, we investigated the effect of conservative and surgical treatment on spinal cord T1 relaxation times in cSCS.MethodsT1‐mapping was performed in 54 patients with cSCS at 3 Tesla MRI at the maximum‐, above and below the stenosis. Subsequently, intraindividual T1‐differences (ΔT1) intrastenosis were calculated. Twenty‐four patients received follow‐up scans after 6 months.ResultsSurgically treated patients showed higher ΔT1 at baseline (154.9 ± 81.6 vs. 95.3 ± 60.7), while absolute T1‐values within the stenosis were comparable between groups (863.7 ± 89.3 milliseconds vs. 855.1 ± 62.2 milliseconds). In surgically treated patients, ΔT1 decreased inverse to stenosis severity. After 6 months, ΔT1 significantly decreased in the surgical group (154.9 ± 81.6 milliseconds to 85.7 ± 108.9 milliseconds, p = .021) and remained unchanged in conservatively treated patients. Both groups showed clinical improvement at the 6‐month follow‐up.ConclusionsBaseline difference of T1 relaxation time (ΔT1) might serve as a supporting marker for treatment decision and change of T1 relaxation time might reflect relief of spinal cord narrowing indicating regenerative processes. Quantitative T1‐mapping represents a promising additional imaging method to indicate a surgical treatment plan and to validate treatment success.