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Published on: April 7, 2015
Reduced Field of View Diffusion-Weighted Imaging in the Evaluation of Congenital Spine Malformations
Rupa Radhakrishnan1, Aaron M Betts1, Marguerite M Care1
1Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Background:
Reduced field of view diffusion-weighted imaging (rFOV DWI) is a more recently described technique in the evaluation of spine pathology. In adults, this technique has been shown to increase clinician confidence in identification of diffusion restricting lesions.
Purpose:
In this study, we evaluate the image quality and diagnostic confidence of the rFOV DWI technique in pediatric spine MRI.
Methods:
We included patients with MRI of the lumbar spine for suspected congenital abnormalities who had conventional SS-EPI (single shot echo planar imaging) with full field of view (fFOV) and rFOV DWI performed. Images were graded for image quality and observer confidence for detection of lesions with reduced diffusion. Position of the conus and L3 vertebral body measurements were recorded. Comparisons were made between the fFOV and rFOV scores.
Results:
Fifty children (30 girls, 20 boys) were included (median 3.6 years). Compared to the fFOV images, the rFOV images scored higher in image quality (P < 0.0001) and for confidence in detecting lesions with reduced diffusion (P < 0.0001). The average spread of identified conus position was smaller for in rFOV compared to fFOV (P = 0.0042). There was no significant difference in the L3 vertebral body measurements between the two methods. In rFOV, the anterior aspects of the vertebral bodies were excluded in a few studies due to narrow FOV.
Conclusion:
rFOV DWI of the lumbar spine in the pediatric population has qualitatively improved image quality and observer confidence for lesion detection when compared to conventional fFOV SS-EPI DWI.
Insights
Reduced field of view diffusion-weighted imaging (rFOV DWI) improves pediatric spine MRI quality and diagnostic confidence for detecting lesions. This technique enhances image quality and observer confidence compared to standard full field of view methods.
Area of Science:
- Radiology
- Medical Imaging
- Pediatric MRI
Background:
- Reduced field of view diffusion-weighted imaging (rFOV DWI) is an emerging technique for spine pathology evaluation.
- In adults, rFOV DWI has demonstrated increased clinician confidence in identifying diffusion-restricting lesions.
Purpose of the Study:
- To assess the image quality and diagnostic confidence of rFOV DWI in pediatric spine MRI.
- To compare rFOV DWI with conventional full field of view (fFOV) SS-EPI DWI in children.
Main Methods:
- Pediatric patients with suspected congenital lumbar spine abnormalities underwent both fFOV and rFOV DWI.
- Images were evaluated for quality and observer confidence in detecting diffusion-restricted lesions.
- Conus position and L3 vertebral body measurements were compared between the two imaging techniques.
Main Results:
- rFOV DWI images showed significantly higher quality and observer confidence compared to fFOV images (P < 0.0001).
- A smaller spread in conus position was observed with rFOV DWI (P = 0.0042).
- No significant difference in L3 vertebral body measurements was found; however, anterior vertebral body exclusion occurred in a few rFOV cases.
Conclusions:
- rFOV DWI offers qualitatively improved image quality and observer confidence for lesion detection in the pediatric lumbar spine.
- This technique is superior to conventional fFOV SS-EPI DWI for pediatric spine imaging evaluations.
