Diffusion-weighted MR imaging of extraaxial tumors

The clinical usefulness of the application of spin-echo diffusion-weighted imaging in the evaluation of extraaxial cysts and epidermoid tumors is demonstrated in a series of 15 patients. Apparent diffusion coefficient (ADC) images based on intravoxel incoherent motion (IVIM) were obtained with a maximum gradient b value = 100 s/mm2. Lesion ADC was qualitatively compared to external phantoms. In all cases, epidermoid tumors revealed reduced ADC values similar to that of normal brain tissue. On the other hand, all cysts had ADC similar to the stationary water phantom. Lesion delineation was improved due to the replacement of normal pulsatile (very high ADC) cisternal CSF. Direct quantitative measurements of ADC using this technique may not be possible due to unavoidable motion artifact.