What can be achieved by using MR-DWI and ADC value in cases of intramedullary spinal cord lesions of non-traumatic causes?

摘要

Background Early diagnosis and management of intra medullary spinal cord lesions is crucial for improving the outcome. This can be achieved by adding DW-MRI to spinal imaging protocol. Patients & methods A prospective study included 42 patients proved to have intramedullary SOLs of non-traumatic causes based on cMRI, were subjected to DWI and ADC value measurement. Our findings were correlated to the clinical outcome in non-neoplastic lesions and o the histopathological results in neoplastic lesions. Results 20 cases of non-neoplastic lesions (group I) showed nonrestricted diffusion with variable increased ADC values (mean?=?1.46?±?0.35?×?10 3 ?mm 2 /s), except in cord acute ischemia which had restricted diffusion and reduced ADC value (mean?=?0.85?±?0.07?×?10 3 ?mm 2 /s). 22 cases of neoplastic lesions (group II) showed reduced ADC values (mean 1.05?±?0.21?×?10 3 ?mm 2 /s), the lowest was in metastatic lesions (mean 0.75?±?0.15?×?10 3 ?mm 2 /s) and medulloblastoma (mean 0.81?±?0.09?×?10 3 ?mm 2 /s) while a diagnostic overlap occurred between astrocytoma and ependymoma (mean 1.19?±?0.07, 1.1?±?0.07?×?10 3 ?mm 2 /s respectively). A cut off value 1.25?×?10 3 ?mm 2 /s was found to differentiate between the two groups. Conclusion Optimum diagnosis for non-traumatic intra-medullary spinal cord lesions can be achieved by using DWI and ADC value measurement.