• Ayhan Demir, Mario Ries, Crit T W Moonen, Jean-Marc Vital, Joël Dehais, Pierre Arne, Jean-Marie Caillé, and Vincent Dousset.
• Department of Neuroradiology, CHU-Pellegrin, Place Amélie Raba-Léon, 33076 Bordeaux, France.
• Radiology. 2003 Oct 1;229(1):37-43.

PurposeTo evaluate diffusion-weighted magnetic resonance (MR) imaging in patients with cervical spondylosis and/or myelopathy.Materials And MethodsA multishot echo-planar imaging sequence with calculation of apparent diffusion coefficient (ADC) and apparent diffusion tensor (ADT) was applied in 36 patients with symptomatic cervical spondylosis. Diffusion-weighted images read by two neuroradiologists were compared with T2-weighted fast spin-echo images read independently by three neuroradiologists with regard to clinical status (n = 36). MR findings in a selected subgroup of 20 patients whose clinical status was confirmed by electrophysiologic examination also were compared. Sensitivity, specificity, positive predictive value, and negative predictive value of both T2-weighted imaging and diffusion-weighted imaging (ADC and ADT) were calculated and compared.ResultsPatients with myelopathy had abnormal ADC (17 of 21) and ADT (15 of 19) maps with increased ADC and ADT values and decreased anisotropy. For the detection of myelopathy, diffusion-weighted ADC maps had a sensitivity of 80% (17 of 21), while T2-weighted images had a sensitivity of 61% (13 of 21). The negative predictive value was 63% (seven of 11) and 60% (12 of 20) for ADC maps and T2-weighted images, respectively. Conversely, the specificity of diffusion-weighted images (53%; seven of 13) was lower than that of T2-weighted images (92%; 12 of 13). In patients with myelopathy confirmed at electrophysiologic examination, the sensitivity of diffusion-weighted images increased to 92% (12 of 13) and the negative predictive value increased to 75% (three of four), while T2-weighted images had a 53% (seven of 13) sensitivity and a 50% (six of 12) negative predictive value.ConclusionDiffusion weighting improved the sensitivity of imaging in cervical spondylotic myelopathy.Copyright RSNA, 2003

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