الفهرس 
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Abstract
Although MRI has long been considered the gold standard for spinal cord imaging, DTI is anovel non invasive technique which has the potential to detect microscopic alterations which are beyond the capability of MRI. It enables qualitative and quantitative assessment of the integrity of the WM tracts. In this study we tried to highlight the role of DTI in differentiation between spinal cord lesions. This study was conducted on 30 patients with myelopathy symptoms referred to radio-diagnosis department from neurology and neurosurgery departments, Tanta University Hospitals over aperiod from January 2019 to January 2021. 17 (56.7%) cases were females and 13 (43.3%) cases were males, their ages ranged from 17 - 60 years with a mean age of 39.3 ± 15.0 years .They were examined for clinical assessment and examined with MRI including DTI technique. 4 groups were studied: 10 cases of inflammation/ demyelination, 8 cases of compressive myelopathy, 8 cases of traumatic spinal cord injury and 4 cases of intramedullary tumors. In inflammation /demyelination group, our study showed that the mean FA values at the site of the lesions (0.394 ± 0.024) was significantly lower than the normal appearing spinal cord (0.553 ± 0.083) and the mean ADC values at the site of the lesions (1.444 ± 0.223) was significantly higher than the normal appearing spinal cord (1.279 ± 0.261) . Also we revealed that there is significant difference in mean FA values between MS and TM subgroups. In compressive myelopathy group , our study showed that the mean FA values at the site of the lesions (0.427 ± 0.118) was significantly lower than the normal appearing spinal cord (0.643 ± 0.061) and the mean ADC values at the site of the lesions (1.153 ± 0.324) was higher than the normal appearing spinal cord (0.962 ± 0.232). In traumatic spinal cord injury group ,our study showed that the mean FA values at injury level (0.221 ± 0.049) was significantly lower than the normal appearing spinal cord (0.361 ± 0.115) and the mean ADC values at injury level ( 2.092 ± 0.849) was higher than the normal appearing spinal cord (1.938 ± 1.084). In intramedullary tumors group ,our study showed that the mean FA values at the site of the lesions (0.207 ± 0.045) was lower than the normal appearing spinal cord (0.209 ± 0.032) and the mean ADC values at the site of the lesions (1.288 ± 0.476) was lower than the normal appearing spinal cord (3.303 ± 0.444). We revealed that DTI help in differentiation between tumors and tumor mimics when we found that tumors tend to have significantly lower mean FA values (0.207 ± 0.045) than demyelinating disorders (0.394 ± 0.024) while mean ADC values was higher in demyelinating disorders (1.444 ± 0.223) than tumors(1.288 ± 0.476). Concerning DTT evaluation of different groups, we revealed specific pattern of fibers affection in each group, helping the differentiation between these groups.