ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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1/2020
vol. 85
 
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Musculoskeletal radiology
abstract:
Original paper

Role of diffusion-weighted magnetic resonance imaging in the evaluation of vertebral bone marrow lesions

Arashdeep Kaur
1
,
Chuni L. Thukral
2
,
Gagan Khanna
3
,
Paramdeep Singh
1

1.
Department of Radiology, Guru Gobind Singh (GGS) Medical College and Hospital, Baba Farid University of Health Sciences, India
2.
Department of Radiodiagnosis and Imaging, Sri Guru Ram Das Institute of Medical Sciences, India
3.
Department of Orthopaedics, Sri Guru Ram Das Institute of Medical Sciences
© Pol J Radiol 2020; 85: e215-e223
Online publish date: 2020/05/04
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Purpose
To evaluate the role of diffusion-weighted magnetic resonance imaging (DW-MRI) in differentiating vertebral marrow pathologies. To determine the sensitivity, specificity, and threshold apparent diffusion coefficient (ADC) values that can aid in the differentiation of malignant from benign bone marrow lesions.

Material and methods
This observational study included 100 patients, who underwent MRI examination with a 1.5 Tesla scanner. The ADC values of normal and pathological vertebrae were estimated, and the threshold ADC values were computed by receiver operating characteristic (ROC) analysis. The results were correlated with histopathological diagnosis, clinical follow-up, and other investigations. Statistical analysis was done by employing unpaired two-tailed Student’s t-test and the p-value of < 0.05 was deemed as statistically significant.

Results
Vertebral bone marrow lesions had a male predominance and there was a predilection towards thoracic and lumbar vertebrae, with L4 being the commonest. Metastasis was the commonest lesion, followed by spondylodiscitis. The mean ADC value of benign pathologies was significantly greater than malignant pathologies (p < 0.05). The threshold value for the demarcation between benign and malignant pathologies was computed to be 1.21 × 10-3 mm2/s. DW imaging had sensitivity of 100%, specificity of 92.31%, positive predictive value of 87.5%, and negative predictive value of 100%.

Conclusions
Vertebral marrow lesions can be differentiated as benign or malignant with good sensitivity and specificity with the help of DW-ADC maps.

keywords:

metastasis, bone marrow, ADC, vertebrae, diffusion MRI, DWI

 
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