Role of Magnetic Resonance Diffusion Imaging and Apparent Diffusion Coefficient Values in the Evaluation of Extradural Spinal Pathologies
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 9
Abstract
Background: In this study, besides, routine imaging additional diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) sequences were applied to extradural pathologies of the spine to increase the diagnostic confidence in differentiating malignant and benign pathologies. Aims: The aims are as follows: (a) To differentiate malignancy from infection qualitatively on the basis of DWI sequence and quantitatively on the basis of ADC values. (b) To assign ADC values for infectious/inflammatory pathologies of the spine. Materials and Methods: This is a prospective study of 53 patients who presented to the department of radiodiagnosis for magnetic resonance imaging spine with extradural spinal pathology. Patients were assessed on 3 Tesla MR SIEMENS LTD. Results: Mean ADC value in abnormal soft tissue was found to be significantly lower in malignant lesion compared to benign (P < 0.0001). Mean ADC value in the affected vertebral body (bone) was found to be significantly lower in malignant lesion compared to benign (P < 0.0001). Diagnostic significance of mean ADC value in the affected vertebral body (bone) was assessed using receiver operating characteristic curve. The area under the curve was found to be 95%, and the diagnostic cutoff for the malignant condition was found to be 1.065 (<1.065 malignant) with sensitivity 100% and specificity 83.3%. Diagnostic significance of mean ADC value in abnormal soft tissue showed the area under the curve was found to be 97.4%, and the diagnostic cutoff for the malignant condition was found to be 1.28 (<1.28 malignant) with sensitivity 100% and specificity 93.3%. Conclusion: In the present study, vertebral bone-marrow pathologies were differentiated as benign or malignant with high sensitivity and specificity with the aid of ADC values calculated from maps obtained by DWI. We conclude that the evaluation of pre/paravertebral soft tissue component should be done to increase the sensitivity and specificity for lesion characterization.
Authors and Affiliations
Nishant Bhargava, Chandra Dev Sahu, Rajesh Singh, Partisha Gupta
Keywords
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