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FIG 4. L2 and L3 metastasis in 70-year-old female patient with uterine cervix carcinoma.
A, T1-weighted MR image (583/12) obtained before radiation therapy shows low signal intensity in metastatic diseases (arrows). Hyperintense bone marrow caused by previous radiation therapy in the pelvic cavity can be seen.
B, T2-weighted MR image (3800/128) obtained before radiation therapy shows low signal intensity in metastatic diseases (arrows).
C, Diffusion-weighted MR image with high b value (650 s/mm2), obtained before therapy, shows slight high signal intensity in the metastatic disease (arrows).
D, Metastatic disease before therapy reveals high signal intensity on ADC maps (arrows). ADC value is (0.82 ± 0.03) x 10-3 mm2/s.
E, T1-weighted MR image (583/12) obtained after radiation therapy shows low signal intensity in metastatic diseases (arrows).
F, T2-weighted MR image (3800/128) obtained after radiation therapy shows low signal intensity in metastatic diseases (arrows).
G, Diffusion-weighted MR image with high b value (650 s/mm2), obtained after therapy, shows hypointensity in metastatic diseases (arrows).
H, ADC maps obtained after therapy reveal high signal intensity (arrows), and the ADC value ([1.33 ± 0.09] x 10-3 mm2/s) is increased. Normal bone marrow on ADC maps appear dark before therapy (as shown in D) and after therapy (as can be seen in this image) because of minimal diffusion of normal bone marrow. On ADC maps, ADC values after therapy are increased compared with those before therapy because of an increased extracellular volume fraction caused by necrosis of the tumor cells and bone marrow elements.
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