Synopsis
DWI
is a powerful addition to the arsenal of MR imaging techniques for the detection
of bone marrow tumor dissemination, improving sensitivity to involvement in a
variety of tumor types (2).
DWI increases
confidence in monitoring treatment response and assisting in the
differentiation of treatment related changes from tumor Distinguishing
between benign and malignant etiologies of vertebral fracture with MRI is
problematic, particularly if only one vertebra is
affected. The value of DWI in discriminating between osteoporotic and metastatic
vertebral fractures is controversial and by consensus insufficiently reliable
(4-6).
DWI
is useful for differentiation of degenerative and infectious endplate
abnormalities (7-9). Symptomatic degenerative vertebral endplate signal changes
(Modic type 1) can be difficult to differentiate from acute spondylodiscitis using
conventional MRI techniques. Several studies have shown that DWI adds value in
differentiating degenerative and infectious endplate abnormalities.
The role of MRS in identifying the painful disc and PET MR in localizing back pain will be discussed
Multiparametric spine Imaging
DWI
is a powerful addition to the arsenal of MR imaging techniques for the detection
of bone marrow tumor dissemination (2).
DWI increases
confidence in monitoring treatment response and assisting in the
differentiation of treatment related changes from tumor (3)(4). Distinguishing
between benign and malignant etiologies of vertebral fracture with MRI is
problematic, particularly if only one vertebra is
affected. The value of DWI in discriminating between osteoporotic and metastatic
vertebral fractures is controversial and by consensus insufficiently reliable
(4-6).
DWI
is useful for differentiation of degenerative and infectious endplate
abnormalities (7-9). Symptomatic degenerative vertebral endplate signal changes
(Modic type 1) can be difficult to differentiate from acute spondylodiscitis using
conventional MRI techniques. Several studies have shown that DWI adds value in
differentiating degenerative and infectious endplate abnormalities.
(8). The value of
excluding the possibility of infection can be seen in reduction in unnecessary,
often invasive ancillary testing and reduced levels of patient concern. DWI may also yield insight into
intervertebral disc degeneration. It has recently been shown in the lumbar
spine that disc degeneration can influence ADC values with negative correlation
between ADC and the degree of disc degeneration (10).
MRS is capable of identifying the phenotype of the painful disc and analagous to the role of provocative discography in patient management. PET MRI can also have a role in localizing back pain and directing therapy.
Acknowledgements
No acknowledgement found.References
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