Diffusion-weighted MR imaging (DWI) in the evaluation of epidural spinal lesions |
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Authors: | Christina Plank Anke Koller Christina Mueller-Mang Roland Bammer Majda M Thurnher |
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Institution: | (1) Department of Radiology, Medical University of Vienna, Vienna, Austria;(2) Department of Pathology, Medical University of Vienna, Vienna, Austria;(3) Lucas MRI/S Center, Department of Radiology, Stanford University, Stanford, USA;(4) Neuroradiology Section, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria |
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Abstract: | Introduction Epidural spinal cord compression is one of the most critical emergency conditions requiring medical attention and requires
prompt and adequate treatment. The aim of our study was to assess the role of diffusion-weighted magnetic resonance (MR) imaging
(DWI) in the diagnosis and differentiation of epidural spinal lesions.
Methods Three patients with epidural lymphoma, two with sarcoma and three with epidural metastatic disease were imaged on a 1.5T MRI
unit. DWI was performed using navigated, interleaved, multi-shot echo planar imaging (IEPI). Three region of interest (ROI)-measurements
were obtained on corresponding apparent diffusion coefficient (ADC) maps, and the mean ADC value was used for further analysis.
The cellularity of tumors was determined as the N/C ratio (nucleus/cytoplasma ratio) from histological samples. The ADC values
and N/C ratios of lesions were compared using a Kruskal-Wallis test.
Results The mean ADC of the lymphomas was 0.66 × 10−3 mm2/s, that of the sarcomas was 0.85 × 10−3 mm2/s and the ADC of the metastatic lesions was 1.05 × 10−3 mm2/s; however, the differences were not statistically significant. Mean N/C ratios in the lymphoma, sarcomas and metastases
were 4:1, 2:1, and 2.6:1, respectively, with a statistically significant difference between the groups (p < 0.025).
Conclusion Although not statistically significant due to the small patient sample, our results clearly show a tendency toward decreased
diffusivity in neoplastic lesions with higher cellularity. The data from our study suggest that DWI is a feasible and potentially
useful technique for the evaluation of epidural lesions that cause spinal cord compression on a per-patient basis. |
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Keywords: | Diffusion weighted imaging Magnetic resonance imaging Spinal cord |
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