{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T03:05:08Z","timestamp":1783393508540,"version":"3.54.6"},"reference-count":47,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T00:00:00Z","timestamp":1646784000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006181","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado da Bahia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006181","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013101","name":"National Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013101","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>In the diagnosis of HTLV\u20101\u2010associated myelopathy (HAM), while magnetic resonance imaging (MRI) is essential to exclude other diseases, its power is limited regarding HAM diagnosis, as only 30% of affected patients present with spinal cord atrophy. Diffusion tensor imaging (DTI) may enable the detection of damage in the white matter microstructure. Here, we quantitatively assess spinal cord damage using DTI and evaluate conventional MRI parameters of the spinal cord in HTLV\u20101\u2010infected individuals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross\u2010sectional study involved 33 HTLV\u20101 carriers, 28 patients with definite\u2010HAM, and 11 seronegative healthy subjects (HS). Region\u2010of\u2010interest (ROI)\u2010based fractional anisotropy (FA) and mean diffusivity (MD) measurements were performed in the upper thoracic and lumbar regions of the spinal cord. Thoracic index was defined as 1\/ (anteroposterior diameter \u00d7 transverse diameter) measured at the fifth 5th vertebral level. Receiver operating characteristic (ROC) curve analysis was used to determine optimal cutoff FA, MD, and thoracic index values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Spinal cord atrophy was observed in 15 (53.6%) patients with definite\u2010HAM. The area under the ROC curve in the thoracic spinal cord was 0.824 (95% CI, 0.716\u20130.932), 0.839 (95% CI: 0.736\u20130.942), and 0.838 (95% CI: 0.728\u20130.949) for FA, MD, and the thoracic index, respectively. Lower FA and higher MD values were observed in the definite\u2010HAM group compared to HTLV\u20101 carriers and HS at the T5 vertebral level (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Complementary to conventional MRI, DTI analysis of the spinal cord and thoracic index determination can offer additional insight that may prove useful in the diagnosis of HAM.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.51521","type":"journal-article","created":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T15:00:35Z","timestamp":1646838035000},"page":"488-496","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Diffusion tensor imaging metrics in diagnosis of <scp>HTLV\u20101\u2010associated<\/scp> myelopathy"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6943-5801","authenticated-orcid":false,"given":"Sheila N. 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