The Usefulness of Diffusion-weighted MR Imaging for Differentiation between Degenerative Spines and Infectious Spondylitis.
- Author:
Won Kyu PARK
1
;
Woo Mok BYUN
;
Joon Hyuk CHOI
Author Information
1. Department of Diagnostic Radiology, College of Medicine, Yeungnam University, Korea. wmbyun@med.yu.ac.kr
- Publication Type:Case Report
- Keywords:
Magnetic resonance (MR), diffusion study;
Spine, disease;
Spine, infection
- MeSH:
Biopsy;
Bone Marrow;
Diagnosis, Differential;
Humans;
Magnetic Resonance Imaging*;
Spine*;
Spondylitis*
- From:Journal of the Korean Society of Magnetic Resonance in Medicine
2002;6(2):152-157
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The differential diagnosis between Modic type I degenerative spine and infectious spondylitis sometimes is difficult, because the affected bone marrows in both disease show similar signal intensity on conventional MR imaging. We evaluate the usefulness of diffusion-wighted MR imaging for differential diagnosis between Modic type I degenerative spine and infectious spondylitis. MATERIALS AND METHODS: The spin-echo and diffusion-weighted MR images of eight patients with Modic type I degenerative spines and 14 patients with infectious spondylitis diagnosed by clinical findings or CTguided biopsies were analyzed. The diffusion-weighted imaging sequence was based on reversed fast imaging with steady-state precession (PSIF). Signal intensity changes of the vertebral bone marrow on conventional spin-echo and diffusion-weighted MR imaging were compared between degenerative spine and infectious spondylitis. RESULTS: On T1-weighted images, the affeted bone marrow in both disease showed hypointense signals. On T2-weighted images, all of type I degenerative spine and 11 of infectious spondylitis showed hyperintensity, and three of infectious spondylitis showed heterogeneous mixed signal intensity. On diffusionweighted MR images, all of type I degenerative spine were hypointense with peripheral high signal intensity to normal vertebral body, but infectious spondylitis was hyperintense (n=11) and hypointense (n=3). CONCLUSION: Diffusion-weighted MR imaging is useful to differentiate Modic type I degenerative spine from infectious spondylitis. On diffusion-weighted images, the high singal intensity of bone marrow suggests infectious spondylitis, whereas the low signal intensity of bone marrow with peripheral focal high signal intensity suggests type I degenerative spine.
