الفهرس 
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Abstract
Cervical spondylotic myelopathy is an age related progressive disorder that can cause severe motor disability; hence its early diagnosis is very important. MRI was the sole imaging technique in CSM diagnosis, due its high ability to show the anatomical structure of cervical spine and spinal cord, however the late appearance of cord abnormality in T1WI and T2WI limit the early diagnosis of CSM.
An advent of new techniques in neuroimaging was directed in order to detect early micro structural abnormality. DTI is one of most researchable new techniques due to its high validity in detection of cord white matter affection and quantitative assessment microstructural abnormalities via assessment of diffusivity of water molecule in the tissue.
Our study aimed to determine the diagnostic value of quantitative DTI indices in assessment of cervical spondylotic myelopathy.
This study included 30 patients (16 female and 14 male) clinically diagnosed with CSM based on mJOA grading system and referred from neurosurgery department to radiological department to perform conventional MRI with DTI technique on 1.5 tesla MRI.
According to conventional MRI interpretation, multilevel cord compression were detected at 20 patients and uni level cord compression at 10 patients, with most affected disc levels at C4/5 in 20 patient followed by C3/4 in 17 patients. 17 patients showed mild cord compression while 13 showed severe cord compression. Based on T2 grading system 14 patients showed grade II and 16 patients showed grade I.
We assessed the DTI metrics at stenotic and non stenotic segments and we graded them according to FA grading into 20 patient with mild grade and 10 patients with moderate grade. We Found that most of DTI metrics especially FA (P value = 0.000) and ADC (P value = 0.000) have significant difference between stenotic and non stenotic segments. We also found significant correlation of mJOA with FA (P value =0.036) and ADC (P value =0.005). While FA show negative correlation with ADC (P value = 0.000) while no significant correlation found between mJOA and T2 hyper-intense cord signal (P value =0.102).
Other DTI metrics were also evaluated at stentoic and non stenotic segments and two of them show significant difference RA (P value= 0.00) and RD (P value= 0.00).