Diagnosis of Different Spinal Lesions by Multi Parametric MRI

Abstract Background: Vertebral marrow lesions in patients with known primary malignancy are a common clinical problem, particularly in elderly patients. In spite of osteoporosis being the commonest cause at this age, the spine also is a common site of metastases, with about 39% of all bone metastases occurring in the spine. Such metastases may result in a pathologic fracture. Recently, multi-parametric MR imaging (mp MRI) has shown the ability to localize, detect, and stage various diseases. Aim of Study: Assess role of Diffusion Tensor Imaging and in phase / opposed phases in diagnosis of different spinal bony lesions. Patient and Methods: This prospective study was per-formed between December 2020 and December 2022 on patients who had spinal bony lesions of both sexes (47 patients; 29 males and 18 females). Only those patients who are willing to participate in study were included. All patients subjected to conventional MRI, DTI, In phase/Opposed phase imaging, FA, MD of malignant and benign lesion were calculated, signal characters in chemical shift images was estimated and subjected for statical analysis. Results: ROC curve analysis revealed that FA cut-off value of 0.550 can differentiate malignant from benign lesions, with sensitivity, specificity and Accuracy of 87.5%, 65.2%, 76.6% respectively. Also MD cut-off value of 0.919 differen-tiate malignant from benign lesions with sensitivity, specificity, and Accuracy of 95.8%, 91.3%, 93.6% respectively. In out of phase images: Malignant lesions included in the study had high SI in 91.7% of them which is statistically significant (p<0.001) from benign lesions which showed signal drop in 87% of them. Conclusion: However, conventional MRI is the imaging modality of choice in detecting and evaluating spinal bony lesions, advanced imaging techniques as DTI and in phase /out of phase images add more accuracy in differentiation and characterization of them.