Pre and postoperative perfusion MRI in degenerative cervical myelopathy suggest different patterns of pathophysiological compensatory mechanisms
Abstract
Introduction: Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord (SC) dysfunction. Conventional MRI, particularly T2-weighted imaging, depicts SC changes well but often fails to provide satisfactory clinico-radiological correlation. We assessed the value of quantitative perfusion MRI-specifically Golden-angle RAdial Sparse Parallel (GRASP) Dynamic Contrast-Enhanced (DCE) MRI. Materials and methods: Thirteen patients with chronic-onset DCM were enrolled. Clinical status was assessed using the modified Japanese Orthopaedic Association (mJOA) scale. Sagittal cervical SC T2-w 3D SPACE imaging and GRASP-DCE mapping were performed at baseline (M0) and 3 months postoperatively (M3). Semiquantitative parameters-area under the curve (AUC60), wash-in (WI), and wash-out (WO)-were derived from time-signal intensity curves to compare regional perfusion pre-and postoperatively. Patients were divided into good (>30%) and poor (<30%) recovery groups based on postoperative mean mJOA Recovery Rate (RR). Results: mJOA grade was mild in 4 patients, moderate in 7, and severe in 2. SC compression was multi-level in 4. Mean postoperative RRmJOA was 31.6% ± 58%. Mean M0 and M3 AUC60, WI, and WO values in the whole cord and compressed zone showed no significant difference across the whole population. However, in the 8 patients with RRmJOA >30%, mean whole-cord AUC60 was significantly higher at M0 than M3 (48.0 ± 7.8 vs. 39.7 ± 6.7; p = 0.024). Conversely, AUC60 and WI increased in the poor-recovery group. Conclusion: GRASP-DCE MRI offers valuable insight into SC perfusion. Divergent AUC60/WI patterns by recovery status suggest two distinct compensatory pathophysiological mechanisms, highlighting the complexity of disease and recovery.
Related
- A systematic review and meta-analysis of quantitative pain outcomes in degenerative thoracic myelopathy
- Drug-induced gastrointestinal toxicity: from pathophysiological mechanisms to human-relevant preclinical models
- STAG2-truncating variants reveal a mosaic STAG2 inactivation pattern and compensatory mechanisms involving cohesin complex remodeling
- High-altitude gastric disorders: insights into maladaptation pathophysiological mechanisms, disease spectrum and prevention strategies
- Lichen planus pigmentosus associated with tamoxifen: clinical presentation and pathophysiological insights
BibTeX
@article{farah2026postoperative,
title = {{Pre and postoperative perfusion MRI in degenerative cervical myelopathy suggest different patterns of pathophysiological compensatory mechanisms}},
author = {Kaissar Farah and Guillaume Frébourg and Lauriane Pini and Thomas Troalen and Maxime Guye and Stéphane Fuentes and Pierre-Hugues Roche and Virginie Callot},
journal = {Neurochirurgie},
year = {2026},
month = nov,
doi = {10.1016/j.neuchi.2026.101862},
url = {https://amu.hal.science/hal-05854820v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Pre and postoperative perfusion MRI in degenerative cervical myelopathy suggest different patterns of pathophysiological compensatory mechanisms
AU - Kaissar Farah
AU - Guillaume Frébourg
AU - Lauriane Pini
AU - Thomas Troalen
AU - Maxime Guye
AU - Stéphane Fuentes
AU - Pierre-Hugues Roche
AU - Virginie Callot
PY - 2026
DA - 2026/11/06
JO - Neurochirurgie
DO - 10.1016/j.neuchi.2026.101862
UR - https://amu.hal.science/hal-05854820v1
AB - Introduction: Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord (SC) dysfunction. Conventional MRI, particularly T2-weighted imaging, depicts SC changes well but often fails to provide satisfactory clinico-radiological correlation. We assessed the value of quantitative perfusion MRI-specifically Golden-angle RAdial Sparse Parallel (GRASP) Dynamic Contrast-Enhanced (DCE) MRI. Materials and methods: Thirteen patients with chronic-onset DCM were enrolled. Clinical status was assessed using the modified Japanese Orthopaedic Association (mJOA) scale. Sagittal cervical SC T2-w 3D SPACE imaging and GRASP-DCE mapping were performed at baseline (M0) and 3 months postoperatively (M3). Semiquantitative parameters-area under the curve (AUC60), wash-in (WI), and wash-out (WO)-were derived from time-signal intensity curves to compare regional perfusion pre-and postoperatively. Patients were divided into good (>30%) and poor (<30%) recovery groups based on postoperative mean mJOA Recovery Rate (RR). Results: mJOA grade was mild in 4 patients, moderate in 7, and severe in 2. SC compression was multi-level in 4. Mean postoperative RRmJOA was 31.6% ± 58%. Mean M0 and M3 AUC60, WI, and WO values in the whole cord and compressed zone showed no significant difference across the whole population. However, in the 8 patients with RRmJOA >30%, mean whole-cord AUC60 was significantly higher at M0 than M3 (48.0 ± 7.8 vs. 39.7 ± 6.7; p = 0.024). Conversely, AUC60 and WI increased in the poor-recovery group. Conclusion: GRASP-DCE MRI offers valuable insight into SC perfusion. Divergent AUC60/WI patterns by recovery status suggest two distinct compensatory pathophysiological mechanisms, highlighting the complexity of disease and recovery.
SN - 0028-3770
SN - 1773-0619
ER -