Publication details
Význam MR zobrazení difuze míchy v diferenciální diagnostice míšních lézí
| Title in English | The role of MR diffusion imaging in the differential diagnosis of the spinal cord lesions |
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| Authors | |
| Year of publication | 2013 |
| Type | Article in Periodical |
| Magazine / Source | CESKA A SLOVENSKA NEUROLOGIE A NEUROCHIRURGIE |
| MU Faculty or unit | |
| Citation | |
| Field | Other medical specializations |
| Keywords | spinal cord diseases; ischemia; diffusion magnetic resonanance; diffusion tensor imaging |
| Description | Diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI) are magnetic resonance imaging methods, nowadays commonly used for the depiction of the brain. Application of these methods for the spinal cord is technically more demanding and less frequently used. The aim of this paper is to evaluate the value of these methods for the differential diagnostics of the spinal cord lesions. We evaluated DWI/DTI findings retrospectively in a group of 11 patients with pathological findings of the spinal cord on conventional MR examination. The diagnosis comprised spinal cord ischemia, multiple sclerosis, myelitis, radiation myelopathy and arteriovenous malformation. We measured apparent diffusion coefficient (ADC) in all patients, from the DTI data we measured also fractional anisotropy (FA) values and evaluated the 3D tractography reconstructions. In 4 patients with spinal cord ischemia we observed the decrease of the ADC values of the spinal cord lesions compared to the normal-appearing segment within a range 36-61%. Small areas of restricted diffusion of the spinal cord were found also in the patient with radiation myelopathy. In 2 patients with spinal cord tumors DTI tractography showed the displacement and/or disruption of the spinal cord tracts and marked decrease of the FA values (0,247 and 0,299). In the other patients no abnormalities were observed on tractography, moderate decrease of the FA values was found within the demyelinating lesions of the spinal cord (0,494 and 0,471). DWI/DTI of the spinal cord may contribute to the correct direction of the differential diagnostic considerations mainly by the depiction of the restricted diffusion in spinal cord ischemia and by evaluation of the 3D tractography in patients with spinal cord tumors. Further research with larger numbers of patients might enable the differentiation of the spinal cord lesions based on the DTI parameters quantification. |