الفهرس 
Anatomy of The SpineOnly 14 pages are availabe for public view
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Abstract
Background: Conventional MR imaging with sequences like T1-weighted spin-echo images (T1WI), T2- fast Spine echo weighted images (T2WI) and /or sagittal short time inversion-recovery (STIR) despite having a high sensitivity for detecting both diffuse and focal bone marrow involvement , has a low specificity in evaluating the causes of these alterations. Because of this low specificity, accurate diagnosis necessitates sometimes invasive diagnostic procedures. Functional MR imaging using diffusion weighted imaging (DWI) and measurement of apparent diffusion coefficient (ADC) values can be used as a non-invasive method of characterizing tissue and thus reach a more specific diagnosis.
Aim of the Work: To determine the diagnostic role of DWI and ADC values in the differentiation of benign and malignant vertebral marrow lesions.
Methods: This is a comparative cross-sectional study which was carried out at Ain Shams University hospitals on 40 patients with either focal or multiple lesions in the spine. The duration of the study was 24 months.
Results: In our study, the mean ADCs of benign lesions were significantly higher than those of malignant lesions, and the best ADC cutoff value for distinguishing benign from malignant lesions was is < 1.25. The mean ADC for benign lesions is 1.27±0.59 and malignant lesions’ mean ADC 0.83±0.18. By using 1.25 as the cutoff point the sensitivity = 97.4% and the specificity = 72%.
Conclusions: The standard spine MRI protocol could be changed to incorporate DWI as a more affordable alternative to MR with contrast scan, particularly in patients who are contraindicated to contrast administration.
Keywords: T1-weighted spin-echo images- T2- fast Spine echo weighted images -Diffusion Weighted Imaging - Apparent Diffusion Coefficient - Vertebral Marrow Lesions –