Precisión de la resonancia magnética en la diferenciación entre lesión vertebral maligna y benigna: papel de las secuencias de difusión, del cociente fuera de fase/en fase y de los valores del coeficiente de difusión aparente

Differential diagnosis of hemangiomas from spinal osteolytic metastases using 3.0 T MRI: comparison of T1-weighted imaging, chemical-shift imaging, diffusion-weighted and contrast-enhanced imaging

“…In our study, accuracy of 74.04% to differentiate hemangiomas from metastases and 84.88% to identification of atypical hemangiomas and metastases were superior to those of other studies that found diagnostic accuracy of 71.7% [ 13 ]. However, our result was inferior to those of other studies that showed high sensitivities of 95% and specificities of up to 100% [ 12 , 15 ]. Our study also showed that accuracy of quantitative assessment of chemical-shift imaging was inferior to that of T1WI with and without fat suppression.…”

“…Chemical-shift MRI was able to quantify microscopic fat tissue. Normal hematopoietic marrow in axial skeleton had microscopic fat component, so a few studies have assessed this technique in spine [ 12 , 13 , 15 ]. If the bone marrow was replaced by metastases, there was lack of signal loss on opposed-phase images [ 13 ].…”

“…The previous authors have described different diagnostic accuracies of ADCs to differentiate malignant skeletal lesions from benign lesions, ranging between 69.6% and 85% [ 11 , 13 , 15 ]. For differentiating of benign and malignant fracture, Geith and colleagues showed a threshold ADC value of 1.48 x 10 -3 mm 2 /s yielded a highest accuracy of 78.3% [ 13 ].…”

“…Ahlawat and colleagues found that the highest accuracy (85%) was determined at a threshold minmum ADC value of ≥ 0.9 x 10 -3 mm 2 /s for differentiating between benign and malignant lesions with a sensitivity of 92% and a specificity of 78% [ 11 ]. Martel Villagrán and colleagues revealed that when the lesion had a cutting point of 0.845 x 10 -3 mm 2 /s for distinguishing benign from malignant vertebral lesions with accuracy of 73% [ 15 ]. In our study, the diagnostic accuracy of ADC to distinguishing atypical hemangiomas from metastases was 89.53%, which was higher than that of previous studies.…”

“…During the last years several articles have been published on use of MR sequences like chemical-shift imaging, diffusion-weighted imaging (DWI), and the apparent diffusion coefficient (ADC) in effort to better distinguish a benign vertebral lesion from a malignant one [ 9 – 15 ]. These studies have shown promising results.…”