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Research ArticleSPINE

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

A.Y. Oner, T. Tali, F. Celikyay, A. Celik and P. Le Roux
American Journal of Neuroradiology March 2007, 28 (3) 575-580;
A.Y. Oner
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T. Tali
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F. Celikyay
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A. Celik
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P. Le Roux
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    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 × 10−3 mm2/s for EPI and non-CPMG SS-FSE DWI, respectively.

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    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 × 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 × 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.

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    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 × 10−3 mm2/s for EPI and non-CPMG SS-FSE DWI, respectively.

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    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 × 10−3 mm2/s for EPI and non-CPMG SS-FSE DWI, respectively.

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    Table 1:

    Mean SNR, ADC values and corresponding image quality scores of the normal lumbar vertebra measured by two different DWI sequences

    SequenceP
    EPI-DWINon-CPMG SS-FSE DWI
    SNR5.83 ± 2.211.68 ± 2.87<.01
    ADC (× 10−3 s/mm2)0.53 ± 0.150.35 ± 0.15<.01
    Image quality scores1.98 ± 0.183.03 ± 0.19<.05
    • Note:—SNR indicates signal-to-noise ratio; ADC, apparent diffusion coefficient; DWI, diffusion-weighted imaging; EPI, echo-planar imaging; non-CPMG, non–Carr-Purcell-Meiboom-Gill; SS-FSE, single-shot fast spin-echo.

      Data are presented as mean ± SD. ADC values were calculated for a “b” value of 600 mm2/s.

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    Table 2:

    Mean CNR and ADC values measured by two different DWI sequences in spinal lesions

    Sequence
    EPI-DWINon-CPMG ssFSE DWI
    CNRADC(10−3 mm2/s)CNRADC(10−3 mm2/s)
    Metastases (n = 6)15.46 ± 5.760.72 ± 0.3115.96 ± 5.810.69 ± 0.30
    Spondylodiskitis (n = 6)4.02 ± 0.901.51 ± 0.255.26 ± 0.931.21 ± 0.24
    Compression fracture (n = 2)10.43 ± 2.951.61 ± 0.4610.78 ± 3.151.54 ± 0.36
    • Note:—CNR indicates contrast-to-noise ratio; ADC, apparent diffusion coefficient; DWI, diffusion-weighted imaging; EPI, echo-planar imaging; non-CPMG, non–Carr-Purcell-Meiboom-Gill; SS-FSE, single-shot fast spin-echo.

      Data are presented as mean ± SD. ADC values were calculated for a “b” value of 600 mm2/s.

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American Journal of Neuroradiology: 28 (3)
American Journal of Neuroradiology
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A.Y. Oner, T. Tali, F. Celikyay, A. Celik, P. Le Roux
Diffusion-Weighted Imaging of the Spine with a Non–Carr-Purcell-Meiboom-Gill Single-Shot Fast Spin-Echo Sequence: Initial Experience
American Journal of Neuroradiology Mar 2007, 28 (3) 575-580;

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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, T. Tali, F. Celikyay, A. Celik, P. Le Roux
American Journal of Neuroradiology Mar 2007, 28 (3) 575-580;
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