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Diffusion-weighted MR imaging (DWI) in the evaluation of epidural spinal lesions

  • Diagnostic Neuroradiology
  • Published:
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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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Conflict of interest statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Medical University of Vienna, Vienna, Austria

    Christina Plank, Christina Mueller-Mang & Majda M. Thurnher

  2. Department of Pathology, Medical University of Vienna, Vienna, Austria

    Anke Koller

  3. Lucas MRI/S Center, Department of Radiology, Stanford University, Stanford, USA

    Roland Bammer

  4. Neuroradiology Section, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Majda M. Thurnher

Authors
  1. Christina Plank
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  2. Anke Koller
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  3. Christina Mueller-Mang
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  4. Roland Bammer
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  5. Majda M. Thurnher
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Corresponding author

Correspondence to Majda M. Thurnher.

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Plank, C., Koller, A., Mueller-Mang, C. et al. Diffusion-weighted MR imaging (DWI) in the evaluation of epidural spinal lesions. Neuroradiology 49, 977–985 (2007). https://doi.org/10.1007/s00234-007-0275-4

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  • DOI: https://doi.org/10.1007/s00234-007-0275-4

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