Keywords:
Neuroradiology brain, Neuroradiology peripheral nerve, Neuroradiology spine
Authors:
Y. Parag, L. N. Tanenbaum, P. S. Pawha; New York, NY/US
DOI:
10.1594/ecr2010/C-3384
Purpose
Traditional metastatic spine surveys employ a combination of T1, T2, STIR and if there are no contraindications, contrast enhanced sequences. Despite this multi-modal assessment, studies are often difficult to interpret. This is particularly true in elderly patients with heterogeneous bone marrow composition/signal and when lesions occur in such locations as the pedicles, articulating facets and vertebral endplates where degenerative changes and Schmorl nodes complicate detection and characterization.
From a microscopic perspective, metastases are composed of densely packed cells that impede water diffusivity in surrounding bone matrix. On the basis of this observation, we suggest using diffusion weighted imaging (DWI) to highlight the presence of spinal metastases.
In the past, various studies have tried to use diffusion weighted imaging to differentiate metastases from benign compression fractures with limited success. We therefore attempted to assess the added value of diffusion imaging in lesion detection and it's contribution to confidence in diagnosis.