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Utility of Diffusion weighted Imaging in Pediatric Spine evaluation 2011

General Spine

Karuna, V, Shekdar, MD
Tamara, Feygin, MD, Non ASSR Member
Erin, Schwartz, MD, Non ASSR Member
Robert, A, Zimmerman, MD, Non ASSR Member

Poster

Purpose

To demonstrate utility of diffusion-weighted imaging in characterization of a wide spectrum of pediatric spine pathology

Methods & Materials

Cases for this study were retrospectively selected from pediatric patient population who had undergone spine imaging, at our institute, from June 2005 to June 2010. Imaging was performed on either 1.5 or 3 T Siemens magnet. Diffusion-weighted (DW) MR imaging with apparent diffusion coefficient (ADC) maps, were included in addition to routine sequences. Examples of different pathologies have been selected from these cases demonstrating restricted diffusion.

Results

Several lesions of varying etiologies demonstrated restricted water diffusion. They could be more specifically characterized into the following categories: A)Cytotoxic edema: seen in acute spinal cord ischemia/infarct; B)Infections: Pus collections as seen in sub-dural empyemas; C)Acute inflammatory and demyelinating conditions; D)Neoplastic lesions: Benign-epidermal inclusion cysts and Malignant-either primary or secondary, small round blue cell tumors, neuroblastoma among others; E)Neuro-toxic complication of chemotherapy; F)Marrow disorders: infective and neoplastic Lack of restricted diffusion and facilitated diffusion in some cases proved useful in providing valuable information impacting immediate patient management. Images of above mentioned pathology will be illustrated in our exhibit.

Conclusion

Diffusion- weighted imaging is a powerful tool in the diagnosis of a wide spectrum of pathologic entities which occur in the pediatric spine. Appreciation of restricted versus facilitated water motion on diffusion weighted imaging increases diagnostic accuracy and in some cases helps prediction of histology.

References/Financial Disclosures

Nothing to disclose

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