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AJNR - American Journal of Neuroradiology

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Diffusion-Weighted Imaging of the Spine with a Non–Carr-Purcell-Meiboom-Gill Single-Shot Fast Spin-Echo Sequence: Initial Experience

A.Y. Oner^a, T. Tali^a, F. Celikyay^a, A. Celik^b and P. Le Roux^c

^a Department of Radiology, Gazi University School of Medicine, Besevler-Ankara, Turkey
^b GE Medical Systems, Istanbul, Turkey
^c GE Healthcare, Global Applied Science Laboratory, Buc, France

View larger version (108K): [in this window] [in a new window]   Fig 1. Sagittal diffusion-weighted images in a 25-year-old man with normal spine MR imaging findings obtained at the same level with 2 different techniques: EPI DWI at b = 600 mm2/s (A) and non-CPMG SS-FSE DWI at b = 600 mm2/s (B) and corresponding apparent diffusion coefficient (ADC) maps (C and D, respectively). Increased signal intensity, with better background suppression is noted with the non-CPMG SS-FSE technique. ADC values for the L3 vertebra are (mean ± SD) 0.51 ± 0.17 and 0.37 ± 0.14 x 10–3 mm2/s for EPI and non-CPMG SS-FSE DWI, respectively.

View larger version (124K): [in this window] [in a new window]   Fig 2. A 46-year-old woman with L2 vertebral compression fracture. Sagittal T1-weighted image (A) and diffusion-weighted images obtained at the same level with 2 different techniques: EPI DWI at b = 600 mm2/s (B), non-CPMG SS-FSE DWI at b = 600 mm2/s (C), and corresponding apparent diffusion coefficient (ADC) maps (D and E, respectively). The compression is more readily appreciated on the non-CPMG SS-FSE images. ADC measured from L3 vertebral body is (mean ± SD x 10–3 mm2/s) 0.54 ± 0.14 and 0.38 ± 0.16 for EPI and non-CPMG SS-FSE DWI, respectively. ADC values measured from L2 vertebra are (mean ± SD) 1.63 ± 0.27 and 1.55 ± 0.24 x 10–3 mm2/s for EPI and non-CPMG SS-FSE DWI, respectively. This reflects the increased diffusion caused by the accompanying bone marrow edema.

View larger version (120K): [in this window] [in a new window]   Fig 3. A 53-year-old man with Brucella species spondylodiskitis involving the L3–L4 vertebrae. Sagittal postcontrast T1-weighted image (A) and diffusion-weighted images obtained at the same level with 2 different techniques: EPI DWI at b = 600 mm2/s (B), non-CPMG SS-FSE DWI at b = 600 mm2/s (C), and corresponding apparent diffusion coefficient (ADC) maps (D and E, respectively). Postcontrast T1-weighted image demonstrates contrast enhancement in the disk and adjacent vertebral body. Spinal involvement is more readily appreciated on non-CPMG SS-FSE images. ADC measured from L3 vertebral body is (mean ± SD) 1.57 ± 0.14 and 1.31 ± 0.17 x 10–3 mm2/s for EPI and non-CPMG SS-FSE DWI, respectively.

View larger version (116K): [in this window] [in a new window]   Fig 4. A 56-year-old man with small-cell lung cancer involving T12 and L4 vertebrae. Sagittal postcontrast T1-weighted image (A) and diffusion-weighted images obtained at the same level with 2 different techniques: EPI DWI at b = 600 mm2/s (B), non-CPMG SS-FSE DWI at b = 600 mm2/s (C), and corresponding apparent diffusion coefficient (ADC) maps (D and E, respectively). Postcontrast T1-weighted image demonstrates mild contrast enhancement at T12 and L4 vertebral body. High signal intensities over T12 and L4 vertebrae are observed on both diffusion images. ADC measured from T12 vertebral body is (mean ± SD) 0.74 ± 0.14 and 0.70 ± 0.17 x 10–3 mm2/s for EPI and non-CPMG SS-FSE DWI, respectively.