Sergiy Kushchayev;
Lee Moffitt Cancer Center and Research Institute
Oleg Teytelboym;
Mercy Catholic Medical Center
Background
The utility of DWI in the spine has been established and continues to grow in clinical practice. DWI raises MR sensitivity of lesion detection and improves conspicuity of many spinal pathologies. Applications include evaluation of spinal cord infarction, bone marrow lesions, infection, degenerative disease, trauma, osteoporosis, malignancy, and response to therapy.
Educational Goals / Teaching Points
We provide a case-based review to illustrate and discuss these uses. We also highlight DWI acquisition techniques and challenges. We provide protocol optimization tips that help to overcome these challenges and permit incorporation of DWI into the workflow.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Infectious and inflammatory disease, primary and metastatic spine tumors, degenerative disease, trauma, spinal cord ischemia, compression fractures, and demyelinating disease.
Conclusion
DWI of the spine is a challenging but rewarding imaging technique that provides insight to spinal pathology beyond that of conventional T1- and T2-weighted imaging, allowing superior conspicuity of lesions, surgical planning, and assessment of treatment response. DWI promises many benefits in evaluating spinal pathology. We believe as the quality of DWI improves, it will gain a wider use in routine spine MRI.
