Keywords:
Cross-sectional study, Prospective, Neoplasia, Diagnostic procedure, MR-Functional imaging, MR-Diffusion/Perfusion, MR, Oncology, Neuroradiology spine, CNS, Neuro, Performed at one institution
Authors:
D. K. M. Khedr, M. tantawy, M. Settein, G. el hawary; Mansoura/EG
DOI:
10.26044/ecr2020/C-04084
Methods and materials
Study population:
This prospective study included 42 patients (24 males and 18 females): 16 cases with intramedullary spinal cord tumors and 26 cases with tumor mimics (Spinal cord inflammation/ demyelination) disorders in the period from January 2017 to January 2018 in Mansoura university hospitals. The inclusion criteria were cases of intramedullary tumors based on pathological bases, MRI examination (Conventional and post-contrast); good general condition of the patient and absence of exogenous implants. Exclusion criteria were: previous spinal surgery or fixation.
Data acquisition:
All MRI examinations were performed using a 1.5 Tesla (T) MRI system Philips system with using of the synergic cervical- thoracic -lumbar coil. Patients were placed in the supine position with head fixed to the table. The MRI protocol consisted of conventional MRI pre and post-contrast and DTI using single-shot echo-planar imaging sequence axial or sagittal iso-medium with b-values of 0 and 800 s/mm2.
Data analysis:
DTI data were transferred to the workstation; Philips Extended MR
workspace 2.6.3.2. Registration of DTI dataset was performed at first to correct the distortion caused by eddy current motions.
The DTI metrics (fractional anisotropy FA and mean diffusivity MD mean values) were measured at the affected cord segment and compared to the remote normal segments of the spinal cord (Proximal and distal to the affected segment on T2WI) which are used as reference values.
The FA color-coded and greyscale maps of all cases were evaluated. Maximum intensity projection (MIP) and the 3D tractography had been constructed and used to visualize the morphological features of the affected spinal cord in all cases.
Statistical analysis:
For statistical analysis, Statistical Package for Social Sciences IBM
SPSS Statistics 21 was used. Differences between the mean DTI values of the measured were tested for significance by a sample t-test. Continuous variables were presented as mean ± SD (standard deviation) for parametric data and median for non-parametric data. P-value of less than 0.05 was considered to indicate a statistically significant difference.