Devoted to diagnostic and interventional spine imaging and therapeutics

Library

Line Scan Diffusion Imaging of the Spine 2005

General Spine

Sanjay - Saluja, MD, Non ASSR Member
Gordon C Sze , MD, ASSR Member
Aditya R Daftary , MBBS, Non ASSR Member

Purpose

Line Scan Diffusion Imaging (LSDI) offers diffusion imaging of the vertebral column that is less susceptible to magnetic susceptibility and motion artifacts compared to other diffusion techniques. The purpose of this study is to assess the feasibility and utility of LSDI of the spine in routine clinical practice.

Methods & Materials

LSDI was routinely performed on all patients undergoing spine imaging regardless of the indication on one of three clinical magnets in a University hospital setting. The protocol was approved by Institutional IRB. Trace diffusion images were obtained after utilizing diffusion gradients in three orthogonal directions. The ‘b’ value used was 650 s/mm2. Images acquired were evaluated on a clinical work station for quantitative assessment.

Results

Over a 90 day period, 110 patients underwent LSDI of the spine. There were 57 males and 53 females, all above the age of 18 years. The predominant finding on the MR was degenerative disc disease. There were 10 patients with metastatic spine disease, 4 patients with old benign compression fractures and 3 patients with acute benign compression fracture. The diffusion values of normal vertebral bodies ranged from 30-138 x 10-6 mm2/s; the diffusion values of the metastatic foci ranged from 162-975 x 10-6 mm2/s; the diffusion values of old benign compression fractures ranged from 37-78 x 10-6 mm2/s while the diffusion values for acute benign compression fractures ranged from 1049-1360 x 10-6 mm2/s. Using the two tailed T tests, the differences between controls vs. metastatic disease are highly significant (p<0.001), metastatic disease versus recent benign fractures highly significant (p<0.001) and controls versus recent benign fractures also significant (p<0.005).

Conclusion

LSDI is a robust method for vertebral column imaging with good image quality. Regarding the application of LSDI, absolute quantitative values of metastatic compression fractures is significantly different from normal vertebral bodies. There is a trend towards different quantitative diffusion values for acute benign compression fractures from malignant fractures that may help in their differentiation. However, since the patients with acute benign disease are few, additional data is being currently collected and will be presented. Other illustrative cases of diffusion imaging in the spine will be presented.