• Medientyp: E-Artikel
  • Titel: Clinical suspicion of spondylodiscitis with equivocal MRI findings : does diffusion-weighted imaging prove helpful here?
  • Beteiligte: Henkelmann, Jeanette [VerfasserIn]; Bremicker, Kristina [VerfasserIn]; Denecke, Timm [VerfasserIn]; Hoffmann, Karl-Titus [VerfasserIn]; Henkelmann, Ralf [VerfasserIn]; Heyde, Christoph-Eckhard [VerfasserIn]; Sabri, Osama [VerfasserIn]; Purz, Sandra [VerfasserIn]
  • Erschienen: Thousand Oaks : s, [2023]
  • Sprache: Englisch
  • Schlagwörter: infection ; magnetic resonance imaging ; Spondylodiscitis ; diffusion-weighted imaging ; spine ; medicine ; degeneration ; Medizin
  • Entstehung:
  • Anmerkungen: Hinweis: Link zur Erstveröffentlichung URL: https://dx.doi.org/10.1177/0284185120927905
  • Beschreibung: Background: Despite the high sensitivity of magnetic resonance imaging (MRI), early detection of spondylodiscitis (SpD) remains challenging due to its low specificity. Purpose: To assess the diagnostic value of diffusion-weighted imaging (DWI) in suspected cases of SpD with ambiguous early MRI findings in the differentiation of degenerative disorders (DD). Material and Methods: In this prospective study, 52 patients suspected of having SpD underwent a whole-spine 3-T MRI scan comprising sagittal DWI. Of 58 conspicuous, T2-weighted, signal increased discs, 39 were successfully evaluated using DWI. Apparent diffusion coefficient (ADC) values and ADC maps were blindly analyzed using the region of interest of the conspicuous disc and a normal adjacent reference disc. Intraindividual ratios (conspicuous disc: reference disc) were calculated. Results: All conspicuous discs showed increased absolute ADC values, which did not differ significantly between SpD (n¼22) and DD (n¼17). However, ADC ratio was significantly higher in SpD vs. DD (P<0.05). In receiver operating characteristic curve analysis, an ADC ratio threshold of 1.6 resulted in 45% sensitivity and 88% specificity (area under the curve¼0.69) for SpD diagnosis. Conclusion: The absolute ADC value does not provide a reliable diagnosis of SpD. Increased diffusivity can be an indication of infection but should always be discussed in the context of existing disc degeneration.
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