title: Advanced MR diffusion tensor imaging and perfusion weighted imaging of intramedullary tumors and tumor like lesions in the cervicomedullary junction region and the cervical spinal cord.
abstract: Differential diagnosis between intramedullary tumors and tumor-like lesions (TLL) in the cervicomedullary junction region and cervical spinal cord is important, sometimes clinical dilemma on conventional MR imaging and empirical treatment. We evaluated advanced MR diffusion tensor imaging (DTI) and perfusion weighted imaging (PWI) in 25 patients, including 12 with intramedullary tumors and 13 with TLL in the cervicomedullary junction region and cervical spinal cord. We found that mean fractional anisotropy value of tumors was significantly lower than the value found in TLL, and the mean trace apparent diffusion coefficient and peak height values of tumors were significantly higher (P < 0.05). The receiver operating characteristic curve analysis showed that peak height was better than any of the other imaging parameters, with a sensitivity of 90.9% and specificity of 80% using a cutoff value of 4.523 to differentiate between tumors and TLL. In conclusion, the MR DTI and PWI could be useful in differentiating between intramedullary tumors and TLL in the cervicomedullary junction region and cervical spinal cord.
authors.affiliation: University of Rochester, Rochester, NY, USA, xiang_liu@urmc.rochester.edu.
authors.forename: Xiang
authors.initials: X
authors.lastname: Liu
authors.forename: Wei
authors.initials: W
authors.lastname: Tian
authors.forename: Balasubramanya
authors.initials: B
authors.lastname: Kolar
authors.forename: Rui
authors.initials: R
authors.lastname: Hu
authors.forename: Yuqing
authors.initials: Y
authors.lastname: Huang
authors.forename: Jason
authors.initials: J
authors.lastname: Huang
authors.forename: Sven
authors.initials: S
authors.lastname: Ekholm
mesh_terms: D000293:Adolescent; D000328:Adult; D016880:Anisotropy; D020295:Brain Stem Neoplasms / Q000473:pathology*; D002574:Cervical Vertebrae; D002648:Child; D002675:Child, Preschool; D056324:Diffusion Tensor Imaging; D005260:Female; D007839:Functional Laterality; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008526:Medulla Oblongata / Q000473:pathology*; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D012372:ROC Curve; D013116:Spinal Cord / Q000473:pathology*; D055815:Young Adult