Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Application of the T1w/T2w mapping technique for spinal cord assessment in patients with degenerative cervical myelopathy

Spinal Cord volume 62, pages 6–11 (2024)Cite this article

Subjects

Abstract

Study design

Retrospective case-control study.

Objectives

To investigate signal changes on T1w/T2w signal intensity ratio maps within cervical cord in patients with degenerative cervical myelopathy (DCM).

Setting

Novosibirsk Neurosurgery Center, Russia.

Methods

A total of 261 patients with DCM and 42 age- and sex-matched healthy controls were evaluated using the T1w/T2w mapping method and spinal cord automatic morphometry. The T1w/T2w signal intensity ratio, which reflects white matter integrity, and the spinal cord cross-sectional area (CSA) were calculated and compared between the patients and the controls. In patients with DCM, the correlations between these parameters and neurological scores were also evaluated.

Results

The regional T1w/T2w ratio values from the cervical spinal cord at the level of maximal compression in patients with DCM were significantly lower than those in healthy controls (p < 0.001), as were the regional CSA values (p < 0.001). There was a positive correlation between the regional values of the T1w/T2w ratio and the values of the CSA at the level of maximal spinal cord compression.

Conclusions

T1w/T2w mapping revealed that spinal cord tissue damage exists at the level of maximal compression in patients with DCM in association with spinal cord atrophy according to automatic morphometry. These changes were correlated with each other.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Illustration of MRI data postprocessing with the Spinal Cord Toolbox.
Fig. 2: Illustration of the T1w/T2w intensity ratio calculation in ImageJ.
Fig. 3: Regional spinal cord CSA values in patients with DCM and healthy controls.
Fig. 4: Regional T1w/T2w ratio values from the spinal cord in patients with DCM and healthy controls.
Fig. 5

Similar content being viewed by others

Data availability

Raw data were generated at Federal Neurosurgical Center Novosibirsk. Derived data supporting the findings of this study are available from the corresponding author on reasonable request.

References.

  1. Yurac R, Matamala JM, Zamorano JJ, Harrop JS, Davies BM, Nouri A. et al. Degenerative cervical myelopathy. Rev Med Chil. 2022;150:339–52.

    Article  PubMed  Google Scholar 

  2. Nouri A, Tessitore E, Molliqaj G, Meling T, Schaller K, Nakashima H, et al. Degenerative cervical myelopathy: development and natural history [AO Spine RECODE-DCM Research Priority Number 2]. Global Spine J. 2022;12:39S.

  3. Badhiwala JH, Ahuja CS, Akbar MA, Witiw CD, Nassiri F, Furlan JC. et al. Degenerative cervical myelopathy - update and future directions. Nat Rev Neurol. 2020;16:108–24.

    Article  PubMed  Google Scholar 

  4. Nouri A, Martin AR, Mikulis D, Fehlings MG Magnetic resonance imaging assessment of degenerative cervical myelopathy: a review of structural changes and measurement techniques. Neurosurg Focus. 2016 [cited 2022 Nov 29];40. Available from: https://pubmed.ncbi.nlm.nih.gov/27246488/.

  5. Kim TH, Ha Y, Shin JJ, Cho YE, Lee JH, Cho WH Signal intensity ratio on magnetic resonance imaging as a prognostic factor in patients with cervical compressive myelopathy. Medicine (United States). 2016 [cited 2022 Dec 7];95. Available from: https://journals.lww.com/md-journal/Fulltext/2016/09270/Signal_intensity_ratio_on_magnetic_resonance.6.aspx.

  6. Ponticorvo S, Manara R, Russillo MC, Erro R, Picillo M, Di Salle G, et al. Magnetic resonance T1w/T2w ratio and voxel-based morphometry in multiple system atrophy. Sci Rep. 2021 Dec 1 [cited 2022 Nov 29];11.

  7. Sasiadek MJ, Szewczyk P, Bladowska J Application of diffusion tensor imaging (DTI) in pathological changes of the spinal cord. Med Sci Monit [Internet]. 2012 [cited 2022 Nov 29];18. Available from: https://pubmed.ncbi.nlm.nih.gov/22648262/.

  8. Liu H, MacMillian EL, Jutzeler CR, Ljungberg E, MacKay AL, Kolind SH, et al. Assessing structure and function of myelin in cervical spondylotic myelopathy: evidence of demyelination. Neurology. 2017;89:602.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Martin AR, De Leener B, Cohen-Adad J, Cadotte DW, Kalsi-Ryan S, Lange SF. et al. A Novel MRI Biomarker of Spinal Cord White Matter Injury: T2*-weighted white matter to gray matter signal intensity ratio. AJNR Am J Neuroradiol. 2017;38:1266–73.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. He B, Sheldrick K, Das A, Diwan A. Clinical and research MRI techniques for assessing spinal cord integrity in degenerative cervical myelopathy: a scoping review. Biomedicines. 2022;10:2621.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Yang HE, Kim WT, Kim DH, Kim SW, Yoo WK, Yang HE. et al. Utility of diffusion and magnetization transfer MRI in cervical spondylotic myelopathy: a pilot study. Diagnostics. 2022;12:2090.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Glasser MF, van Essen DC. Mapping human cortical areas in vivo based on myelin content as revealed by T1- and T2-weighted MRI. J Neurosci. 2011;31:11597.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. De Leener B, Lévy S, Dupont SM, Fonov VS, Stikov N, Louis Collins D, et al. SCT: Spinal Cord Toolbox, an open-source software for processing spinal cord MRI data. Neuroimage. 2017;145:24–43.

    Article  PubMed  Google Scholar 

  14. Ganzetti M, Wenderoth N, Mantini D. Whole brain myelin mapping using T1- and T2-weighted MR imaging data. Front Hum Neurosci. 2014;8:671.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Hannoun S, Kocevar G, Codjia P, Barile B, Cotton F, Durand-Dubief F. et al. T1/T2 ratio: a quantitative sensitive marker of brain tissue integrity in multiple sclerosis. J Neuroimag. 2022;32:328–36.

    Article  Google Scholar 

  16. Pareto D, Garcia-Vidal A, Alberich M, Auger C, Montalban X, Tintoré M. et al. Ratio of T1-weighted to T2-weighted signal intensity as a measure of tissue integrity: comparison with magnetization transfer ratio in patients with multiple sclerosis. Am J Neuroradiol. 2020;41:461–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Fischl B. FreeSurfer. Neuroimage. 2012;62:774.

    Article  PubMed  Google Scholar 

  18. Martin AR, de Leener B, Cohen-Adad J, Cadotte DW, Kalsi-Ryan S, Lange SF, et al. Clinically feasible microstructural MRI to quantify cervical spinal cord tissue injury using DTI, MT, and T2*-weighted imaging: assessment of normative data and reliability. AJNR Am J Neuroradiol. 2017;38:1257–65.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Cohen-Adad J, Alonso-Ortiz E, Abramovic M, Arneitz C, Atcheson N, Barlow L, et al. Open-access quantitative MRI data of the spinal cord and reproducibility across participants, sites and manufacturers. Scientific Data 2021 8:1 [Internet]. 2021 Aug 16 [cited 2022 Dec 1];8:1–17. Available from: https://www.nature.com/articles/s41597-021-00941-8.

  20. Teraguchi M, Yamada H, Yoshida M, Nakayama Y, Kondo T, Ito H. et al. Contrast enrichment of spinal cord MR imaging using a ratio of T1-weighted and T2-weighted signals. J Magn Reson Imaging. 2014;40:1199–207.

    Article  PubMed  Google Scholar 

  21. Bansal R, Hao X, Liu F, Xu D, Liu J, Peterson BS. The effects of changing water content, relaxation times, and tissue contrast on tissue segmentation and measures of cortical anatomy in MR images. Magn Reson Imaging [Internet]. 2013;31:1709.

    Article  CAS  PubMed  Google Scholar 

  22. Boaventura M, Sastre-Garriga J, Garcia-Vidal A, Vidal-Jordana A, Quartana D, Carvajal R, et al. T1/T2-weighted ratio in multiple sclerosis: a longitudinal study with clinical associations. 2022.

Download references

Author information

Authors and Affiliations

  1. Federal Center of Neurosurgery Novosibirsk, Novosibirsk, Russia

    Elena Filimonova, Vladimir Letyagin, Boris Zaitsev, Yulij Kubetsky & Jamil Rzaev

  2. Novosibirsk State Medical University, Novosibirsk, Russia

    Elena Filimonova & Jamil Rzaev

  3. Department of Neuroscience, Institute of Medicine and Psychology, Novosibirsk State University, Novosibirsk, Russia

    Jamil Rzaev

Authors
  1. Elena Filimonova
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vladimir Letyagin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Boris Zaitsev
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yulij Kubetsky
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jamil Rzaev
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conceptualization, EF, VL, and JR; methodology, EF, VL, and BZ; formal analysis, EF and VL; data curation, YK and JR; investigation, EF, BZ, and VL; resources, JR; writing—original draft preparation, EF and BZ; writing—review and editing, JR and YK; visualization—EF; supervision, YK and JR; project administration, JR. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Elena Filimonova.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethical approval

Data acquisition and publication were in accordance with the principles outlined in the Declaration of Helsinki. The study was approved by the local Ethics Committee of the Federal Center for Neurosurgery, Novosibirsk, Russia (protocol No. 6 dated 02-08-2022).

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Filimonova, E., Letyagin, V., Zaitsev, B. et al. Application of the T1w/T2w mapping technique for spinal cord assessment in patients with degenerative cervical myelopathy. Spinal Cord 62, 6–11 (2024). https://doi.org/10.1038/s41393-023-00941-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41393-023-00941-y

Search

Advanced search

Quick links