Magnetic Resonance Imaging with Diffusion in Differentiation between Spinal Canal Lesions

Abstract

Background: Diffusion weighted imaging (DWI) offers distinct contrast information, which complements the data obtained from  conventional magnetic resonance imaging (MRI) by detecting microstructural alterations.

Objective: This work aimed to evaluate the role  of MRI with DWI in differentiation between variant spinal canal lesions.

Individuals and Methods: This prospective work was  conducted on 30 individuals of both sexes with neurological symptoms and spinal canal pathology (back pain, pressure in neck, back or  head, weakness, numbness and tingling or loss of sensation in hands, fingers, or feet). MRI and DWI-MRI are assessed for all patients.   

Results: Area under curve (AUC) of 0.972 and an apparent diffusion coefficient (ADC) cutoff of ≤ 1.25 could predict malignant lesions with  88.5% sensitivity and 92.4% specificity. Malignant lesion had statistically significant higher diffusion restriction as appeared from the DWI  and from the ADC (p<0.001). No statistically substantial variations had been existed in the lesion site (p=0.16) T1 (p=0.081) or T2 (p=0.607)  appearance. Patients with malignant masses had higher mean age, however, without statistical significance (p=0.379). No statistically  substantial variation had been noted in the sex distribution, or the clinical presentation.

Conclusions: Spinal canal lesions encompass a  wide range of neoplastic and non-neoplastic conditions, posing diagnostic challenges due to their often-similar appearance on routine  MRI sequences.