Limits...
Diffusion tensor imaging studies of cervical spondylotic myelopathy: a systemic review and meta-analysis.

Guan X, Fan G, Wu X, Gu G, Gu X, Zhang H, He S - PLoS ONE (2015)

Bottom Line: Meta-regression analysis revealed that male ratio of CSM patients had a significant effect on reduction of FA at MCL (P = 0.03).The meta-analysis of DTI studies of CSM patients clearly demonstrated a significant FA reduction and ADC increase compared with healthy subjects.This result supports the use of DTI parameters in differentiating CSM patients from health subjects.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.

ABSTRACT
A meta-analysis was conducted to assess alterations in measures of diffusion tensor imaging (DTI) in the patients of cervical spondylotic myelopathy (CSM), exploring the potential role of DTI as a diagnosis biomarker. A systematic search of all related studies written in English was conducted using PubMed, Web of Science, EMBASE, CINAHL, and Cochrane comparing CSM patients with healthy controls. Key details for each study regarding participants, imaging techniques, and results were extracted. DTI measurements, such as fractional anisotropy (FA), apparent diffusion coefficient (ADC), and mean diffusivity (MD) were pooled to calculate the effect size (ES) by fixed or random effects meta-analysis. 14 studies involving 479 CSM patients and 278 controls were identified. Meta-analysis of the most compressed levels (MCL) of CSM patients demonstrated that FA was significantly reduced (ES -1.52, 95% CI -1.87 to -1.16, P < 0.001) and ADC was significantly increased (ES 1.09, 95% CI 0.89 to 1.28, P < 0.001). In addition, a notable ES was found for lowered FA at C2-C3 for CSM vs. controls (ES -0.83, 95% CI -1.09 to -0.570, P < 0.001). Meta-regression analysis revealed that male ratio of CSM patients had a significant effect on reduction of FA at MCL (P = 0.03). The meta-analysis of DTI studies of CSM patients clearly demonstrated a significant FA reduction and ADC increase compared with healthy subjects. This result supports the use of DTI parameters in differentiating CSM patients from health subjects. Future researches are required to investigate the diagnosis performance of DTI in cervical spondylotic myelopathy.

Show MeSH
Flow of identification of relevant studies.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4363894&req=5

pone.0117707.g001: Flow of identification of relevant studies.

Mentions: The method used to search relevant studies was presented in the flow diagram ofFig. 1. The initialliterature search yielded 1016 original articles. The search strategy wasextremely liberal, in order to capture all possible articles for inclusion inthis review. After discarding 86 duplicate studies, we screened 930 studies foreligibility. From the remaining 930 potential candidates, 894 were excludedaccording to selection criteria. 10 studies were excluded because they did notcompare CSM patients with healthy controls. 7 studies were discarded becausethey did not provide sufficient data to calculate the effect size. 4 studiescomparing the DTI changes in specific ROIs or tracts instead of the whole spinalcord were excluded. 1 study investigating other causes of chronic spinal cordcompression was excluded. Finally, 10 studies were included in ourmeta-analysis, involving 479 CSM patients and 278 healthy controls [12,19–31]. Demographic details ofthe included studies were listed in Table 1, and relevant technical factors werepresented in Table 2.Assessment of study quality was summarized in Table 3.


Diffusion tensor imaging studies of cervical spondylotic myelopathy: a systemic review and meta-analysis.

Guan X, Fan G, Wu X, Gu G, Gu X, Zhang H, He S - PLoS ONE (2015)

Flow of identification of relevant studies.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4363894&req=5

pone.0117707.g001: Flow of identification of relevant studies.
Mentions: The method used to search relevant studies was presented in the flow diagram ofFig. 1. The initialliterature search yielded 1016 original articles. The search strategy wasextremely liberal, in order to capture all possible articles for inclusion inthis review. After discarding 86 duplicate studies, we screened 930 studies foreligibility. From the remaining 930 potential candidates, 894 were excludedaccording to selection criteria. 10 studies were excluded because they did notcompare CSM patients with healthy controls. 7 studies were discarded becausethey did not provide sufficient data to calculate the effect size. 4 studiescomparing the DTI changes in specific ROIs or tracts instead of the whole spinalcord were excluded. 1 study investigating other causes of chronic spinal cordcompression was excluded. Finally, 10 studies were included in ourmeta-analysis, involving 479 CSM patients and 278 healthy controls [12,19–31]. Demographic details ofthe included studies were listed in Table 1, and relevant technical factors werepresented in Table 2.Assessment of study quality was summarized in Table 3.

Bottom Line: Meta-regression analysis revealed that male ratio of CSM patients had a significant effect on reduction of FA at MCL (P = 0.03).The meta-analysis of DTI studies of CSM patients clearly demonstrated a significant FA reduction and ADC increase compared with healthy subjects.This result supports the use of DTI parameters in differentiating CSM patients from health subjects.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.

ABSTRACT
A meta-analysis was conducted to assess alterations in measures of diffusion tensor imaging (DTI) in the patients of cervical spondylotic myelopathy (CSM), exploring the potential role of DTI as a diagnosis biomarker. A systematic search of all related studies written in English was conducted using PubMed, Web of Science, EMBASE, CINAHL, and Cochrane comparing CSM patients with healthy controls. Key details for each study regarding participants, imaging techniques, and results were extracted. DTI measurements, such as fractional anisotropy (FA), apparent diffusion coefficient (ADC), and mean diffusivity (MD) were pooled to calculate the effect size (ES) by fixed or random effects meta-analysis. 14 studies involving 479 CSM patients and 278 controls were identified. Meta-analysis of the most compressed levels (MCL) of CSM patients demonstrated that FA was significantly reduced (ES -1.52, 95% CI -1.87 to -1.16, P < 0.001) and ADC was significantly increased (ES 1.09, 95% CI 0.89 to 1.28, P < 0.001). In addition, a notable ES was found for lowered FA at C2-C3 for CSM vs. controls (ES -0.83, 95% CI -1.09 to -0.570, P < 0.001). Meta-regression analysis revealed that male ratio of CSM patients had a significant effect on reduction of FA at MCL (P = 0.03). The meta-analysis of DTI studies of CSM patients clearly demonstrated a significant FA reduction and ADC increase compared with healthy subjects. This result supports the use of DTI parameters in differentiating CSM patients from health subjects. Future researches are required to investigate the diagnosis performance of DTI in cervical spondylotic myelopathy.

Show MeSH