Diagnosis of Spinal Metastasis: Usefulness of Additional Diffusion-Weighted Imaging

Abstract

Purpose To determine the usefulness of diffusion weighted-MRI (DW-MRI) in the evaluation of spinal metastasis. Materials and Methods From July to August 2017, 48 whole-spine DW-MRI to detect metastasis in patients with extra-spinal tumors were retrospectively evaluated by three radiologists. The usefulness of DW-MRI was evaluated in four groups based on the change in confidence rating between two sessions: 1 (T1-and T2-weighted and contrast-enhanced images) and 2 (additional DW-MRI). The associations of the usefulness with age, sex, primary cancer, bone type with metastasis, number of probable metastatic segments in session 1, and anatomic locations were assessed in vertebral body and posterior element cases. Results According to the readers 1, 2, and 3, there were 18, 19, and 16 vertebral body cases, respectively, and 12, 13, and 9 posterior element cases, respectively. In the group with no excepted metastasis, DW-MRI was useful in 52-59% of vertebral body cases and 39-67% of posterior element cases. There were no significant differences in the usefulness with respect to the number of probable metastatic segments in session 1, age, sex, primary cancer, bone type with metastasis, or anatomic location. Conclusion DW-MRI could be used to evaluate spinal metastasis. However, there were no differences in the usefulness with respect to the anatomic location.

Imaging Findings of Spinal Metastases with Differential Diagnosis: Focusing on Solitary Spinal Lesion in Older Patients

“…골전이를 진단하는데 있어서 확산강조영상(diffusion weighted imaging)은 기존의 고식적인 MRI 영상에 추가되었을 때 유용성이 입증되었고 척추 압박골절에 대한 평가에서 병적골절과 양성 골다공증성 골절의 감별에도 도움이 된다는 연구가 있다( 21 22 23 24 25 ). 또한, 자기공명분광법(magnetic resonance spectroscopy) 외에도 최근에 개발된 modified Dixon 기법을 이용하여 골수내 지방을 정량화하면 골전이와 양성 골병변의 구분에 유용하게 이용될 수 있다는 보고가 있다( 25 26 ).…”