The usefulness of CT perfusion in differentiation between neoplastic and tuberculous disease of the spine.
BACKGROUND
Routine diagnostic techniques are not sufficient to confidently differentiate diseases of the axial skeleton. Purpose of study was to determine whether CT perfusion (CTP) can differentiate inflammatory diseases like tuberculosis from neoplastic diseases of spine.


METHODS
Fifty-one patients with vertebrdraft%freshal body lesions associated with paraspinal mass underwent CT guided bone biopsy and histopathological evaluation. CTP was done before doing bone biopsy. Perfusion parameters like blood volume (BV), blood flow (BF), and time to peak (TTP) were calculated. Values are correlated with histopathological report of bone biopsy. Statistical analysis was done using Mann-Whitney test. P value < .05 was considered significant.


RESULTS
Of 51, 32 had infective osteomyelitis and 19 neoplastic disease (9 metastasis, 5 plasmacytoma, 4 lymphoma and 1 chordoma. Mean rBF was [inflammatory lesions, 1.79 and neoplastic lesions, 9.42 (P < .000)]. Mean rBV was [inflammatory disease, 1.63 and neoplastic lesions, 9.37 (P < .000)].


CONCLUSIONS
CTP technique has potential for differentiating inflammatory from neoplastic lesions affecting spine associated with paraspinal mass noninvasively.
Shankar
J
J
Department of Diagnostic Imaging-Neuroradiology Section, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada. shivajai1@rediffmail.com
Jayakumar
P
P
Vasudev
M
M
Ravishankar
S
S
Sinha
N
N
D000328:Adult; D000368:Aged; D001810:Blood Volume; D001811:Blood Volume Determination; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis / Q000000981:diagnostic imaging*; D055420:Perfusion Imaging; D012039:Regional Blood Flow; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging*; D013131:Spine / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000473:pathology; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014399:Tuberculosis, Spinal / Q000175:diagnosis / Q000000981:diagnostic imaging*; D055815:Young Adult