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Role of Diffusion Weighted Imaging ‎Sequences to Differentiate between ‎Modic Change Type 1 and ‎Spondylodiscitits

    Authors

    1 Al-Imamian Al-Kadhimyian medical city - Baghdad- Iraq.‎

    2 Iraqi board of medical specilization/ Medical collage/ Al-Nahrain ‎University.‎ Baghdad- Iraq‎

,

Document Type : Research Paper

Abstract

Background: Diffusion Weighted Imaging (DWI) has gained increasing use in
diagnosing pathology in the spine, and is becoming valuable in the assessment of
a variety of diseases including tumor and infection. Modic type 1degenerative ‎changes on conventional MR imaging can mimicor suggest infection, leading to ‎additional costly and sometimes invasiveinvestigations.‎
Aims: To study the role of DWI in uncertain (doubtful) cases with overlapping ‎conventional MRI signal features between Modic1 degenerativechange and ‎infectious spondylodiscitis and describe different patterns of diffusionrestriction.
Patients and methods: Cross sectional study was done at radiology department
of Al-Imamain Al Kadhimain Medical city.Studywas done from October 2021 ‎and November 2022 with a convenient sample of 53patients. The patients were ‎sent for spinalMRI and had clinically suspected to have Modic type 1change or ‎discitis.Conventional MRI with sagittal DWI was done for all patients. Patients ‎were classified as either had Modictype 1 degenerative changes or discitis.
Results: Thirty-six of patients (68%) were Modic type 1 degenerative changes
and 17 (32%) patients had spondylodiscitis.The definite Claw sign was found ‎among 19(52.8%) of the patients, probableClaw sign found among 10(27.8%), ‎questionable Claw sign foundamong 6(16.7%)of the patients, while none of ‎those (0%) of those with spondylodiscitis had thesesigns. Diffused Abnormal ‎DWI (negative claw sign) signal found among 1(2.8%)of those with Modic 1 in ‎comparison to 3(16.7%) of those with discitis.‎
Conclusion: DWI is useful for differentiating Modic type 1 degenerative changes ‎andinfectious spondylodiscitis. The claw sign is useful and accurate sign for ‎distinguishing Modic type 1 endplatedegenerative changes from spondylodiscitis.‎
Key words: Diffusion Weighted Imaging, Modic Change, Spondylodiscitits.‎

Keywords

Main Subjects

References
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Iraqi Postgraduate Medical Journal
Volume 23, Issue 4
October 2024
Page 442-449
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