Abstract

ABSTRACT:
BACKGROUND:
Atypical vertebral hemangioma and metastatic spinal lesions share many MRI signal intensity and
appearance in common ,thats why differentiation between them is crucial. For two decades,
diffusion-weighted imaging (DWI) has been applied to the evaluation of intracranial diseases, but
DWI technical advancement make it possible to apply for assessment of extra cranial sites,
including vertebral column.
OBJECTIVE:
The goal of our study is to assess the value of diffusion weighted MRI imaging in differentiating
vertebral atypical hemangiomas from metastatic lesions.
PATIENTS AND METHODS:
A prospective cross-sectional study was employed at AL-Imammain AL-Khadymain Medical city
in Baghdad health directorate, (43)patients with total (65) vertebral lesions grouped into three
groups Group(A) 10 patients (23.2%)with total (15) lesions of vertebral typical hemangiomas,
Group(B) 13 patients (30.3%) with total ( 13) lesions of vertebral atypical hemangiomas and
Group (C) 20 patients(46.5%) with total ( 37) lesions of spinal vertebral metastases .
MRI was done for all patients (including T1, T2, T1 fat suppression with IV contrast
administration (when needed) and DWI). Complementary non contrast CT was also done.
RESULTS:
Total study sample were (43) patients with total (65) lesions, with (29/43) females and (14/43)
males with male to female ratio of (1:2), their age range from (28-75 years) and their mean age
was (54.2+ 10.1 years). Atypical hemangioma and malignant lesions were generally low signal in
T1 and high or intermediate signal in T2 WI. Restricted diffusion and low ADC values were seen
in atypical hemangioma compared with metastasis with mean ADC value were (1.426+0.231.6x10
-3mm2/s and 0.6182+ 0.137x10-3mm2/s respectively).
Complementary CT confirmed the lytic or sclerotic nature of malignant lesions while in
haemangiomas, it showed their characteristic striated (polka dot) appearance.
CONCLUSION:
Diffusion weighted Magnetic Resonance Imaging is a valuable tool in differentiation of atypical
hemangioma and metastasis of spine with high sensitivity and specificity with the aid of ADC
values calculated from the maps obtained by DWI.
KEYWORDS: diffusion weighted magnetic resonance imaging, atypical haemangiomas,
metastasis.