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

Background 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 (Delta T1) intrastenosis were calculated. Twenty-four patients received follow-up scans after 6 months.ResultsSurgically treated patients showed higher Delta T1 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, Delta T1 decreased inverse to stenosis severity. After 6 months, Delta T1 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 (Delta T1) 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.