Echo‐planar DWI variants: A comparative study in vertebral marrow pathology

Abstract

PurposeSingle‐shot echo‐planar imaging (ss‐EPI) has limited application in vertebral column imaging due to numerous artifacts. Therefore, we aimed to compare readout‐segmented echo‐planar imaging (rs‐EPI) to ss‐EPI and assess its value in the differential diagnosis of vertebral infectious, tumoral infiltrative, and degenerative disorders.Materials and MethodsSixty‐six adult patients with spondylodiscitis (SD, n = 26), tumoral infiltration (TI, n = 20), or Modic type I degeneration (DE, n = 20) findings on spinal magnetic resonance imaging (MRI) included in this retrospective study. Two radiologists scored images for quality on a 4‐point scale (image resolution, degree of geometric distortion, lesion selectivity, and diagnostic reliability) and measured signal intensity (SI), apparent diffusion coefficient (ADC), signal‐to‐noise ratio (SNR), and contrast‐to‐noise ratio (CNR). DE and SD groups also united to form the benign group.ResultsIn all groups, rs‐EPI performed better than ss‐EPI in image quality, SNR, and CNR (p < .05). The difference between mean pathological ADC (ADCP) in the two sequences was statistically significant (p < .05). There was no significant difference between the groups in terms of ADCP in rs‐EPI (p = .229), unlike ss‐EPI (p = .025). Pathological SI (SIP) and CNR in rs‐EPI were significantly higher in the malignant group than benign group (p = .002, p < .001). In rs‐EPI, no significant difference was found between malignant and benign groups' ADCP (p = .13).ConclusionThe rs‐EPI is a diffusion‐weighted imaging (DWI) method with higher image quality that diminishes motion‐induced phase errors and increases resolution through phase corrections. However, the distinction of malignant and benign vertebral bone marrow pathologies is unsatisfactory for rs‐EPI compared with ss‐EPI.