Suraj Serai PhD, Presenter: Nothing to Disclose

Suchandrima Banerjee, Abstract Co-Author: Employee, General Electric Company

Marguerite Care MD, Abstract Co-Author: Nothing to Disclose

Aaron Betts MD, Abstract Co-Author: Nothing to Disclose

Rupa Radhakrishnan MBBS, Abstract Co-Author: Nothing to Disclose

Blaise Vincent Jones MD, Abstract Co-Author: Nothing to Disclose

Diffusion-weighted imaging has the potential to substantially enhance assessment of the child with congenital spine abnormalities, by increasing sensitivity and confidence in the identification of restricting lesions such as dermoid/epidermoid inclusion cysts and abscesses. Current commercially available EPI techniques for DWI are plagued by severe susceptibility artifact and image distortion, limiting their clinical value and acceptance. Reduced FOV (rFOV) DWI is a new technique where the excited FOV is reduced in the phase-encoding direction by using a 2D spatially selective echo-planar RF excitation pulse. This technique has the potential to improve image quality and increase acceptance of spinal DWI as a useful clinical tool in pediatric MR imaging. This study compares this new technique with standard EPI based DWI in children referred for suspected or known congenital spine abnormalities.

This study was performed under an IRB approved protocol. 55 pediatric patients referred for MR imaging of the lumbar spine for known or suspected congenital spine malformations had imaging that included both the rFOV DWI (0.25 phase FOV) and routine EPI DWI sequences. Studies were performed on a 1.5T GE HDx MRI scanner with 40 mT/m maximum gradient strength and 150 mT/m ms maximum slew rate using an 8-channel Spine coil. The individual diffusion-weighted series were evaluated independently by 3 reviewers for lesion detection, image quality, and confidence in diagnosis.

The rFOV DWI scans scored higher on measures of image quality (ref. figure) and reviewer confidence. Objective measures of image quality were more consistent for the rFOV sequences for all reviewers.

When imaging the pediatric spine for congenital malformations, the rFOV technique substantially improves image quality and radiologist confidence in comparison to standard EPI based DWI techniques.

Diffusion-weighted imaging has the potential to increase sensitivity and confidence in the diagnosis of lesions that complicate the management of children with congenital spine abnormalities, but it has been sparingly used because of problems with susceptibility artifact that degrades image quality. By reducing this artifact, rFOV should result in more routine use of DWI in the spine in children, with an associated increase in the ability to detect restricting lesions such as dermoid and epidermoid inclusion cysts.

Serai, S, Banerjee, S, Care, M, Betts, A, Radhakrishnan, R, Jones, B, Evaluation of rFOV DWI in Patients with known or Suspected Congenital Spine Malformations.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045448.html