Apparent diffusion coefficient and fractional anisotropy in spinal cord: Age and cervical spondylosis-related changes

Purpose: To present the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) change with age in the normal spinal cord and in cervical spondylosis. Materials and Methods: A total of 11 normal volunteers and 79 cervical spondylosis patients entered this study. Line scan diffusion tensor images were obtained in a 1.5-Tesla whole-body scanner using a phased-array spine coil. The ADC and FA values were measured on a sagittal section. Spearman correlation of ADC/FA vs. age for normal spinal cord was calculated. Results: The mean ADC of the normal spinal cord was 0.81 +/- 0.03 mu m(2)/msec at the relatively wide C2-C3 level and 0.75 +/- 0.06 mu m(2) /msec at the more narrow C4-C7 level. The FA at the corresponding level was 0.70 +/- 0.05 and 0.66 +/- 0.03, respectively. With age, ADC showed positive correlation (Spearman, r = 0.242) and FA exhibited negative correlation (Spearman, r = -0.244). A total of 54% of all spondylosis cases showed elevated ADC (P < 0.001) and decreased FA (P < 0.001) at the stenotic spinal canal level compared with the normal spinal cord. The average ADC and FA of high-signal lesions on T2-weighted images (seven patients) were 1.28 +/- 0.33 mu m(2)/mscc and 0.46 +/- 0.12, respectively. Conclusion: ADC increases and FA decreases with age in the normal spinal cord. Elevated ADC and reduced FA were measured in the spinal cord of spondylosis cases with clinical symptoms of myelopathy.