Role of Diffusion-Weighted MR Imaging in Differentiation
of Infectious Spondylodiscitis and Spinal Malignancy
Theeraphol Panyaping MD1, Supika Wansophonkul MD1, Lojana Tuntiyatorn MD1
Affiliation :
1 Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Objective : To compare apparent diffusion coef(cid:976)icient [ADC] values between infectious spondylodiscitis and spinal malignant tumors.
In addition, to determine sensitivity, speci(cid:976)icity, accuracy, positive predictive value [PPV], and negative predictive value [NPV] using
ADC value cutoff point for diagnosis of infectious spondylodiscitis.
Materials and Methods : Eighteen patients with 53 vertebral marrow lesions of suspected infectious spondylodiscitis or spinal
malignant tumors acquired between March 2015 and March 2016 were prospectively performed diffusion-weighted MR imaging
with ADC mapping. The authors measured the minimal ADC values [min ADC], mean ADC values [mean ADC] and maximal ADC
values [max ADC] of the enhancing lesions or hyperintense T2 marrow lesions. These parameters were compared between infectious
spondylodiscitis and spinal malignant tumors to (cid:976)ind the ADC value cutoff point for diagnosis of infectious spondylodiscitis.
Results : The mean ADC values of the infectious spondylodiscitis were found to be signi(cid:976)icantly higher than those of the spinal
malignant tumors, 1.30±0.28 x10-3 mm2/second and 1.10±0.20 x10-3 mm2/second, respectively. Sensitivity, speci(cid:976)icity, accuracy,
PPV, and NPV of the diagnosis of infectious spondylodiscitis using mean ADC value cutoff points of 1.116x10-3 mm2/second were
75%, 68%, 71.7%, 72.4%, and 70.8%, respectively.
Conclusion : Diffusion-weighted MR imaging has a role in differentiating between infectious spondylodiscitis and spinal malignant
tumors, especially when imaging (cid:976)indings on conventional images are inconclusive.
Keywords : MRI, DWI, ADC value, Infectious spondylodiscitis, Spinal malignant tumors
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