Diffusion Magnetic Resonance Imaging to Differentiate Degenerative From Infectious Endplate Abnormalities in the Lumbar Spine
Diffusion Magnetic Resonance Imaging to Differentiate Degenerative From Infectious Endplate Abnormalities in the Lumbar Spine
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DOI：
10.1097/brs.0b013e3181d5ff05
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发表时间：
2011-02-01
期刊：
影响因子：
3
通讯作者：
Takahashi, Kazuhisa
中科院分区：
文献类型：
--
作者：
Eguchi, Yawara;Ohtori, Seiji;Takahashi, Kazuhisa
研究设计。对健康志愿者和腰椎退行性和感染性终板异常患者的回顾性观察研究。目的。我们的目的是使用 1.5-T 磁共振成像 (MRI) 评估弥散加权成像 (DWI) 对于区分退行性和感染性终板异常的有用性。背景数据摘要。 DWI 可以提供有关组织的有价值的结构信息，这些信息可能有助于临床应用区分退行性和感染性终板异常。方法。研究人员对 16 名连续腰椎 MRI 检测到的终板异常患者和 15 名健康志愿者进行了研究。 DWI 采用全身成像进行，背景身体信号抑制，b 值为 1000 s/mm(2)。计算正常和异常椎骨骨髓的表观扩散系数值。结果。 16 名患者中发现 29 处脊椎异常。 5名患者中的9个椎体异常是由于感染引起的，11名患者中的20个椎体异常是由于退行性变化引起的； 7 个节段被划分为 Modic 1 型，7 个节段被划分为 2 型，6 个节段被划分为 3 型。DWI 在所有感染患者中均显示出高信号，与正电子发射断层扫描中使用的类似，但在任何退行性疾病患者的椎间隙中均未显示高信号。感染性骨髓的表观扩散系数值显着高于正常和退变性骨髓。结论。 DWI 可用于区分退行性和感染性终板异常。此外，与正电子发射断层扫描相比，MRI由于缺乏电离辐射、成本低、成像时间快而在临床上得到广泛应用。因此，DWI 有潜力用作筛查工具。
Study Design. A retrospective observational study of healthy volunteers and patients with degenerative and infectious endplate abnormalities in the lumbar spine.Objectives. Our purpose was to evaluate the usefulness of diffusion-weighted imaging (DWI) for the differentiation of degenerative and infectious endplate abnormalities using 1.5-T magnetic resonance imaging (MRI).Summary of Background Data. DWI can provide valuable structural information about tissues that may be useful for clinical applications in differentiation between degenerative and infectious endplate abnormalities.Methods. Sixteen consecutive patients with endplate abnormalities that was detected by MRI of the lumbar spine, and 15 healthy volunteers were studied. DWI was performed using whole-body imaging with background body signal suppression with a b value of 1000 s/mm(2). Apparent diffusion coefficient values of normal and abnormal vertebral bone marrow were calculated.Results. Twenty-nine vertebral abnormalities were found in 16 patients. Nine vertebral abnormalities in 5 patients were because of infections and 20 vertebral abnormalities in 11 patients were because of degenerative changes; 7 levels were classified as Modic type 1, 7 levels as type 2, and 6 levels as type 3. DWI showed hyperintensity in all patients with infection, similar to that used in positron emission tomography, but not in the intervertebral spaces of any patients with degenerative disease. Apparent diffusion coefficient values of infectious bone marrowwere significantly higher than normal and degenerative bone marrow.Conclusion. DWI is useful for differentiation of degenerative and infectious endplate abnormalities. Moreover, MRI is widely used clinically because of the lack of ionizing radiation, low cost, and fast imaging time as compared with positron emission tomography. Therefore, DWI has the potential to be used as a screening tool.