Diffusion-weighted imaging (DWI) in musculoskeletal MRI: a critical review

Abstract

Magnetic resonance imaging (MRI) is the mainstay of diagnosis, staging and follow-up of much musculoskeletal pathology. Diffusion-weighted magnetic resonance imaging (DWI) is a recent addition to the MR sequences conventionally employed. DWI provides qualitative and quantitative functional information concerning the microscopic movements of water at the cellular level. A number of musculoskeletal disorders have been evaluated by DWI, including vertebral fractures, bone marrow infection, bone marrow malignancy, primary bone and soft tissue tumours; post-treatment follow-up has also been assessed. Differentiation between benign and malignant vertebral fractures by DWI and monitoring of therapy response have shown excellent results. However, in other pathologies, such as primary soft tissue tumours, DWI data have been inconclusive in some cases, contributing little additional information beyond that gained from conventional MR sequences. The aim of this article is to critically review the current literature on the contribution of DWI to musculoskeletal MRI.

MRI for Response Assessment In Oncologic Bone Marrow Lesions

“…DWI is able to detect changes in water diffusion that occur after therapy as a result of changes in cellular density and loss of membrane integrity (Charles-Edwards and deSouza 2006; Padhani 2011). The impeded water mobility observed in tumoral tissue will decrease or disappear in relation with the loss of cellular integrity in response to treatment, for example due to the occurrence of necrosis (Charles-Edwards and deSouza 2006; Khoo et al 2011;Koh et al 2007). Comparison of two consecutive examinations obtained in a treated patient provides a rapid and generally non ambiguous evaluation of the disease response or progression under therapy (Fig.…”

“…Though single-shot echo planar imaging (SS-EPI) is the most common technique of acquisition, multi-shot EPI (MS-EPI), single-shot fast spin echo (SS-FSE) or steady state free precession (SSFP) can also used in DWI (Khoo et al 2011). Diffusion can be hypothesized isotropic or anisotropic, thus modifying the orientation and the number of diffusions gradients to be used.…”

Advanced imaging of skeletal manifestations of systemic mastocytosis

“…Diffusion-weighted imaging is furthermore a promising tool for the assessment and monitoring of bone marrow abnormalities [57]. Diffusion-weighted images of infiltrated bone marrow frequently show restricted diffusion, although the benefit of diffusion-weighted imaging in comparison to conventional MR imaging is currently not known (Figs.…”

A Study on Optimized MRI Fat-Saturation Technique for Brachial Plexus Patients : Focused on SPAIR and STIR Fat-Saturation

“…CNR을 평가하는 방법으로 식 (2)와 같이 적용하였다 [16] . [17][18][19] . 본 실험에서 SPAIR T2 기법은 낮은 신호대 잡 음비와 영상의 질을 떨어지는 영상을 획득하였지만, 기존 보고에 의하면 복부 검사 시 지방소거 기법으로 우수한 영상정보를 제공하기도 하였다 [20][21] .…”