Abstract
Purpose: Diffusion-weighted MR imaging (DW-MRI) is generally applied to diagnose intra-axial brain pathologies such as parenchyma metastasis, abscesses, and infarcts in patients with systemic cancer. This study aimed to evaluate the DW-MRI findings in cranial bone marrow metastases to facilitate diagnosis. Material and Methods: Conventional MR imaging and DW-MRI findings of 57 patients with cranial bone marrow metastases were evaluated retrospectively. These images were evaluated by two neuroradiologists for lesion detection and lesion consciousness. Reader agreement was assessed by κ statistics. Results: Fifty-seven patients exhibited 113 cranial bone marrow metastases. The sensitivities of DW-MRI and the apparent diffusion coefficient to detect cranial bone metastasis for all types of primary malignancy were 86% and 90%, respectively. The sensitivities of T1-weighted imaging (T1WI), fluid attenuation inversion recovery, contrast-enhanced fat-suppressed (CE-FS) T1WI, and T2WI sequences to detect cranial bone metastasis were 93%, 90%, 89%, and 84%, respectively. Regarding lesion conspicuousness, DW-MRI was equivalent to CE-FS T1WI and equivalent or superior to non-contrast conventional sequences in most of the cranial bone marrow metastases. Interobserver agreement was excellent. Conclusions: DW-MRI is generally indicated not only to assess the diagnosis of parenchyma involvement, but also to discover the cranial bone marrow metastasis in patients with systemic cancer.
References
- Newton H, B.Neurologic complications of systemic cancer. Am Fam Physician. 1999;59:878-86.
- Lee EK, Lee EJ, Kim MS, Park HJ, Park NH, Park SII, Lee YS. Intracranial metastases: spectrum of MR imaging findings. Acta Radiol. 2012;53: 1173-85.
- Silva JR Jr, Hayashi D, Yonenaga T ,Fukuda K, Genant HK, Lin C,et al. MRI of bone marrow abnormalities in hematological malignancies.Diagn Interv Radiol. 2013;19:393-9.
- Castillo M, Arbelaez A, Smith JK, Fisher LL. Diffusion-weighted MR Imaging Offers No Advantage over Routine Noncontrast MR Imaging in the Detection of Vertebral Metastases AJNR Am J Neuroradiol. 2000;21:948–53.
- Moon WJ, Lee MH, Chung EC. Diffusion-Weighted Imaging with Sensitivity Encoding (SENSE) for Detecting Metastases:Comparison with T1-Weighted Images. Korean J Radiol. 2007;8:185-91. Marrow
- Baur A, Stabler A, Bruning R,Bartl R, Krödel A, Reiser M, Deimling M. Diffusion-weighted MR imaging of bone marrow: differentiation of benign versus pathologic compression fractures. Radiology. 1998;207:349-55
- Le Bihan D, Breton E, Lallemand D, Aubin ML, Vignaud J, Laval-Jeantet M. Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging.Radiology. 1988;168:497-505.
- Nemeth AJ, Henson JW,Mullins ME, Gonzalez RG, Schaefer PW. Improved Detection of Skull Metastasis with Diffusion-Weighted MR Imaging AJNR Am J
- Neuroradiol. 2007;28:1088 –92
Abstract
Amaç: Difüzyon ağırlıklı MR (DAG-MR) görüntüleme genellikle sistemik kanserli hastalarda parankim metastazı, abse ve infart gibi intraaksiyel beyin patolojilerinin tanısında kullanılmaktadır. Bu çalışmada DAG –MR’nin kranial kemik iliği metastazlarının tanısındaki değeri araştırılmıştır. Materyal ve Metod: Kranial kemik iliği metastazı saptanan 57 hastanın konvansiyonel MR ve DAG-MR görüntüleri geriye dönük olarak değerlendirildi. Görüntüler 2 nöroradyolog tarafından lezyon saptanması ve göze çarpıcılığı açısından incelendi. Radyologların kappa uyumuna bakıldı. Bulgular: Elli yedi hastada toplam 113 kranial kemik iliği metastazı saptandı. DAG-MR ve ADC’ nin lezyon saptama sensitivitesi sırasıyla %86 and %90 saptandı.T1, FLAIR, kontrastlı yağ baskılamalı T1 ve T2 ağırlıklı sekansların lezyon saptanmasında sensitivitesi sırasıyla %93, %90, % 89, ve %84 saptandı. DAG-MR’nin lezyon göze çarpıcılığı kontrastlı T1 ağırlıklı görüntülere eşit, diğer konvansiyonel sekanslara eşit ya da üstündü. Radyologların kappa uyumu mükemmeldi. Sonuç: DAG-MR sadece parankim tutulumunu değerlendirme değil, kemik iliği metastazlarını da değerlendirmede kullanılabilir
Keywords
References
- Newton H, B.Neurologic complications of systemic cancer. Am Fam Physician. 1999;59:878-86.
- Lee EK, Lee EJ, Kim MS, Park HJ, Park NH, Park SII, Lee YS. Intracranial metastases: spectrum of MR imaging findings. Acta Radiol. 2012;53: 1173-85.
- Silva JR Jr, Hayashi D, Yonenaga T ,Fukuda K, Genant HK, Lin C,et al. MRI of bone marrow abnormalities in hematological malignancies.Diagn Interv Radiol. 2013;19:393-9.
- Castillo M, Arbelaez A, Smith JK, Fisher LL. Diffusion-weighted MR Imaging Offers No Advantage over Routine Noncontrast MR Imaging in the Detection of Vertebral Metastases AJNR Am J Neuroradiol. 2000;21:948–53.
- Moon WJ, Lee MH, Chung EC. Diffusion-Weighted Imaging with Sensitivity Encoding (SENSE) for Detecting Metastases:Comparison with T1-Weighted Images. Korean J Radiol. 2007;8:185-91. Marrow
- Baur A, Stabler A, Bruning R,Bartl R, Krödel A, Reiser M, Deimling M. Diffusion-weighted MR imaging of bone marrow: differentiation of benign versus pathologic compression fractures. Radiology. 1998;207:349-55
- Le Bihan D, Breton E, Lallemand D, Aubin ML, Vignaud J, Laval-Jeantet M. Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging.Radiology. 1988;168:497-505.
- Nemeth AJ, Henson JW,Mullins ME, Gonzalez RG, Schaefer PW. Improved Detection of Skull Metastasis with Diffusion-Weighted MR Imaging AJNR Am J
- Neuroradiol. 2007;28:1088 –92
Details
| Primary Language | English |
|---|---|
| Journal Section | Research |
| Authors | |
| Publication Date | September 30, 2015 |
| Published in Issue | Year 2015 Volume: 40 Issue: 3 |
