Lumbar vertebral chordoma: diffusion-weighted imaging findings are helpful to narrow the differential diagnosis. A case report

Sartoretti–Schefer, Sabine; Oberle, Joachim; Binkert, Christoph A.; Pfofe, Denis; Gutzeit, Andreas

doi:10.1016/j.clinimag.2012.02.022

Cited by 3 publications

(2 citation statements)

References 22 publications

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“…Besides its use for intervertebral disk, assessment of the tissue diffusion phenomenon may improve our understanding of other normal and pathological features of degenerating spine and bring new insight to the diagnosis and treatment of degenerative spinal disorders [ 2 , 3 ]. Some specific uses of ADC maps in regards to discovertebral complex include analysis of bone mineral density of lumbar vertebrae [ 4 ], diagnosis of a lumbar vertebral chordoma [ 5 ], or response of myeloma to treatment [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Apparent diffusion coefficient maps in the assessment of surgical patients with lumbar spine degeneration

et al. 2017

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PurposeTo assess the utility of apparent diffusion coefficient (ADC) maps for the assessment of patients with advanced degenerative lumbar spine disease and describe characteristic features of ADC maps in various degenerative lumbar spinal conditions.MethodsT1-weighted, T2-weighted and diffusion weighted (DWI) MR images of 100 consecutive patients admitted to the spinal surgery service were assessed. ADC maps were generated from DWI images using Osyrix software. The ADC values and characteristic ADC maps were assessed in the regions of interest over the different pathological entities of the lumbar spine.ResultsThe study included 452 lumbar vertebral segments available for analysis of ADCs. Characteristic ADC map features were identified for protrusion, extrusion and sequester types of lumbar disk herniations, spondylolisthesis, reactive Modic endplate changes, Pfirrmann grades of IVD degeneration, and compromised spinal nerves. Compromised nerve roots had significantly higher mean ADC values than adjacent (p < 0.001), contralateral (p < 0.001) or adjacent contralateral (p < 0.001) nerve roots. Compared to the normal bone marrow, Modic I changes showed higher ADC values (p = 0.01) and Modic 2 changes showed lower ADC values (p = 0.02) respectively. ADC values correlated with the Pfirrmann grading, however differed from herniated and non-herniated disks of the matched Pfirrmann 3 and 4 grades.ConclusionQuantitative and qualitative evaluation of ADC mapping may provide additional useful information regarding the fluid dynamics of the degenerated spine and may complement standard MRI imaging protocol for the comprehensive assessment of surgical patients with lumbar spine pathology. ADC maps were advantageous in differentiating reactive bone marrow changes, and more precise assessment of the disk degeneration state. ADC mapping of compressed nerve roots showed promise but requires further investigation on a larger cohort of patients.

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Section: Introductionmentioning

confidence: 99%

Apparent diffusion coefficient maps in the assessment of surgical patients with lumbar spine degeneration

et al. 2017

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“…Some of the specific uses of ADC maps regarding the disco-vertebral complex include diagnosis of lumbar vertebral chordoma [ 34 ], evaluation of bone mineral density of vertebrae [ 35 ], or response of myeloma to treatment [ 36 ].…”

Section: Reviewmentioning

confidence: 99%

Role of Apparent Diffusion Coefficient in Evaluating Degeneration of the Intervertebral Disc: A Narrative Review

Sood¹,

Mishra²,

Suryadevara³

et al. 2023

Cureus

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Degeneration of the lumbar intervertebral disc is the most common cause of lower back pain. It is directly related to daily activities, mechanical stress, and other biological factors. We use imaging modalities to assess the degree of disc degeneration, out of which magnetic resonance imaging (MRI) is the most popular non-invasive modality. It is believed that early changes in disc degeneration are due to the biochemical events in the disc and can be evaluated by sequences in MRI involving the diffusion of water molecules. The apparent diffusion coefficient (ADC) is one such sequence that captures the signals based on the diffusion of water molecules. Ten articles were chosen from PubMed and Google Scholar using the MeSH terms 'lumbar spine degeneration' and 'apparent diffusion coefficient'. This review article has summarized various studies intending to gain a better understanding of the biochemical events leading to the development of disc degeneration. This study has also gathered the role of various sequences in MRI that can quantitatively assess disc degeneration.

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Les chordomes

et al. 2014

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Many different pathologies derived from the notochord can be observed: some are remnants, some may be precursors of chordomas and some have similar features but are probably not genuine chordomas. To-day, immuno-histological studies should permit to differentiate them from real chordomas. Improving knowledge of molecular biology raises hopes for complementary treatments but to date the quality of surgical resection is still the main factor of prognosis. Complementary protontherapy seems useful, especially in skull base chordomas, which have better overall results than those of the craniocervical junction and of the cervical spine. However, we are still lacking an intrinsic marker of evolution to differentiate the slow growing chordomas with an indolent evolution from aggressive types leading rapidly to recurrence and death on which more aggressive treatments should be applied.

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Lumbar vertebral chordoma: diffusion-weighted imaging findings are helpful to narrow the differential diagnosis. A case report

Cited by 3 publications

References 22 publications

Apparent diffusion coefficient maps in the assessment of surgical patients with lumbar spine degeneration

Apparent diffusion coefficient maps in the assessment of surgical patients with lumbar spine degeneration

Role of Apparent Diffusion Coefficient in Evaluating Degeneration of the Intervertebral Disc: A Narrative Review

Les chordomes

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