Korean J Radiol.  2016 Oct;17(5):590-597. 10.3348/kjr.2016.17.5.590.

Single-Shot Echo-Planar Diffusion-Weighted MR Imaging at 3T and 1.5T for Differentiation of Benign Vertebral Fracture Edema and Tumor Infiltration

• Park HJ
• Lee SY
• Rho MH
• Chung EC
• Kim MS
• Kwon HJ
• Youn IY

• KMID: 2458051
• DOI: http://doi.org/10.3348/kjr.2016.17.5.590

Abstract

OBJECTIVE
To compare the apparent diffusion coefficient (ADC) value using single-shot echo-planar imaging sequences at 3T and 1.5T for differentiation of benign fracture edema and tumor infiltration of the vertebral body.
MATERIALS AND METHODS
A total of 46 spinal examinations were included in the 1.5T MRI group, and a total of 40 spinal examinations were included in the 3T MRI group. The ADC values of the lesion were measured and calculated. The diagnostic performance of the conventional MR image containing sagittal T2-weighted fat saturated image and each diffusion weighted image (DWI) with an ADC value with different b values were evaluated.
RESULTS
The mean ADC value of the benign lesions was higher than that of the malignant lesions on 1.5T and 3T (p < 0.05). The sensitivity of the diagnostic performance was higher with an additional DWI in both 1.5T and 3T, but the sensitivities were similar with the addition of b values of 400 and 1000. The specificities of the diagnostic performances did not show significant differences (p value > 0.05). The diagnostic accuracies were higher when either of the DWIs (b values of 400 and 1000) was added to routine MR image for 1.5T and 3T. Statistical differences between 1.5T and 3T or between b values of 400 and 1000 were not seen.
CONCLUSION
The ADC values of the benign lesions were significantly higher than those of the malignant lesions on 1.5T and 3T. There was no statistically significant difference in the diagnostic performances when either of the DWIs (b values of 400 and 1000) was added to the routine MR image for 1.5T and 3T.

Keyword

MR; Diffusion; Spine; Fractures; Compression; DWI; ADC

MeSH Terms

Adult
Aged
Aged, 80 and over
Bone Marrow Diseases/*diagnostic imaging
Diagnosis, Differential
Diffusion Magnetic Resonance Imaging/methods
Echo-Planar Imaging/methods
Edema/*diagnostic imaging
Female
Humans
Male
Middle Aged
Sensitivity and Specificity
Spinal Fractures/*diagnostic imaging
Spinal Neoplasms/diagnosis/*diagnostic imaging/secondary

Figure

• 

  Fig. 1 Diffusion weighted image with b value of 0 in 60-year-old woman with lung cancer metastasis. Regions of interest were placed within lesion of vertebral body.

• 

  Fig. 2 58 years old man with oropharyngeal carcinoma metastasis. A. 3T MRI T2-weighted sagittal image (TR/TE, 2500/120) shows metastatic lesion in S1 (arrow). B. Diffusion weighted image with b value of 0. Regions of interest were placed within lesion (lower circle) and normal marrow (upper circle) of vertebral body. C. Diffusion weighted image with b value of 400. D. Diffusion weighted image with b value of 1000. E. ADC map with b value of 0–400. Region of interest were placed within lesion. F. ADC map with b value of 0–1000. G. ADC map with b value of 0–400–1000. First, both readers diagnosed lesion as malignant based on routine MR images. During second session, both readers diagnosed lesion as malignant based on routine MR images with additional information of DWI with b value 400. During third session, readers (both reader 1 and reader 2) diagnosed lesion as malignant based on routine MR images with additional information of DWI with b value 1000. ADC = apparent diffusion coefficient, DWI = diffusion weighted image, TE = echo time, TR = repetition time

• 

  Fig. 3 Graph shows mean apparent diffusion coefficient (ADC) values (× 10-6 mm2/sec). A. Benign lesion. B. Malignant lesion. R1 = reader 1, R2 = reader 2

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