Hussein, N., kadhim, M. (2024). Role of Diffusion Weighted Imaging ‎Sequences to Differentiate between ‎Modic Change Type 1 and ‎Spondylodiscitits. , 23(4), 442-449. doi: 10.52573/ipmj.2024.141224
Noor ‎ Adil Hussein; Mohammed Abd kadhim. "Role of Diffusion Weighted Imaging ‎Sequences to Differentiate between ‎Modic Change Type 1 and ‎Spondylodiscitits". , 23, 4, 2024, 442-449. doi: 10.52573/ipmj.2024.141224
Hussein, N., kadhim, M. (2024). 'Role of Diffusion Weighted Imaging ‎Sequences to Differentiate between ‎Modic Change Type 1 and ‎Spondylodiscitits', , 23(4), pp. 442-449. doi: 10.52573/ipmj.2024.141224
Hussein, N., kadhim, M. Role of Diffusion Weighted Imaging ‎Sequences to Differentiate between ‎Modic Change Type 1 and ‎Spondylodiscitits. , 2024; 23(4): 442-449. doi: 10.52573/ipmj.2024.141224

Role of Diffusion Weighted Imaging ‎Sequences to Differentiate between ‎Modic Change Type 1 and ‎Spondylodiscitits

Iraqi Postgraduate Medical Journal
Article 11, Volume 23, Issue 4, October 2024, Pages 442-449    PDF (403.6 K)
Document Type: Research Paper
DOI: 10.52573/ipmj.2024.141224
Authors
Noor ‎ Adil Hussein1; Mohammed Abd kadhim* 2
1Al-Imamian Al-Kadhimyian medical city - Baghdad- Iraq.‎
2Iraqi board of medical specilization/ Medical collage/ Al-Nahrain ‎University.‎ Baghdad- Iraq‎
Abstract
Background: Diffusion Weighted Imaging (DWI) has gained increasing use in
diagnosing pathology in the spine, and is becoming valuable in the assessment of
a variety of diseases including tumor and infection. Modic type 1degenerative ‎changes on conventional MR imaging can mimicor suggest infection, leading to ‎additional costly and sometimes invasiveinvestigations.‎
Aims: To study the role of DWI in uncertain (doubtful) cases with overlapping ‎conventional MRI signal features between Modic1 degenerativechange and ‎infectious spondylodiscitis and describe different patterns of diffusionrestriction.
Patients and methods: Cross sectional study was done at radiology department
of Al-Imamain Al Kadhimain Medical city.Studywas done from October 2021 ‎and November 2022 with a convenient sample of 53patients. The patients were ‎sent for spinalMRI and had clinically suspected to have Modic type 1change or ‎discitis.Conventional MRI with sagittal DWI was done for all patients. Patients ‎were classified as either had Modictype 1 degenerative changes or discitis.
Results: Thirty-six of patients (68%) were Modic type 1 degenerative changes
and 17 (32%) patients had spondylodiscitis.The definite Claw sign was found ‎among 19(52.8%) of the patients, probableClaw sign found among 10(27.8%), ‎questionable Claw sign foundamong 6(16.7%)of the patients, while none of ‎those (0%) of those with spondylodiscitis had thesesigns. Diffused Abnormal ‎DWI (negative claw sign) signal found among 1(2.8%)of those with Modic 1 in ‎comparison to 3(16.7%) of those with discitis.‎
Conclusion: DWI is useful for differentiating Modic type 1 degenerative changes ‎andinfectious spondylodiscitis. The claw sign is useful and accurate sign for ‎distinguishing Modic type 1 endplatedegenerative changes from spondylodiscitis.‎
Key words: Diffusion Weighted Imaging, Modic Change, Spondylodiscitits.‎
Keywords
Diffusion Weighted Imaging,,; ,،Modic Change,,; ,،Spondylodiscitits‎
References
  1. Herren C, Jung N, Pishnamaz M, Breuninger M, Siewe J, Sobottke R Spondylodiscitis: diagnosis and treatment options—a systematic review. DtschArzteblInt 2017; 114:875–82.
  2. Baryeh K, Anazor F, Iyer S, Rajagopal T. Spondylodiscitis in adults: diagnosis and management. British Journal of Hospital Medicine.2022:1-9.
  3. Splendiani A, Bruno F, Marsecano C, Arrigoni F, Di Cesare E, Barile A, et al. Modic I changes size increase from supine to standing MRI correlates with increase in pain intensity in standing position: uncovering the "biomechanical stress" and "active discopathy" theories in low back pain. Eur Spine J. 2019;28:983–92.
  4. Modic MT, Ross JS. Lumbar degenerative disk disease.Radiology. 2007;245:43-61.
  5. Herlin C, Kjaer P, Espeland A, Skouen JS, Leboeuf‑Yde C, Karppinen J, et al. Modic changes‑their associations with low back pain and activity limitation: a systematic literature review and meta‑analysis. PLoS One. 2018;13:e0200677.
  6. Hopayian K, Raslan E, Soliman S. The association of modic changes and chronic low back pain: A systematic review. Journal of Orthopaedics.2022 .
  7. Kanna RM, Shanmuganathan R, RajagopalanVR .Prevalence, patterns, and genetic association analysis of modic vertebral endplate changes. Asian Spine J, 2017;11:594–600.
  8. Filograna L, Magarelli N, Cellini F, Manfrida S, Leone A, Colosimo C, Valentini V. Difusion weighted imaging (DWI) and apparent difusioncoefcient (ADC) values for detection of malignant vertebral bone marrow lesions. Eur Rev Med PharmacolSci ,2018; 22:590–97.
  9. Eguchi Y, Ohtori S, Yamashita M, Yamauchi K, Suzuki M, Orita S, et al. Diffusion magnetic resonance imaging to differentiate degenerative from infectious endplate abnormalities in the lumbar spine. Spine (Phila Pa 1976). 2011;36:E198–202.
  10. Daghighi MH, Poureisa M, Safarpour M, Behzadmehr R, Fouladi DF, Meshkini A, et al. iffusion‑weighted magnetic resonance imaging in differentiating acute infectious spondylitis from degenerative Modic type 1 change; the role of b‑value, apparent diffusion coefficient, claw sign and amorphous increased signal. Br J Radiol. 2016;89:20150152.
  11. Dallaudiere B, Dautry R, Preux PM, Perozziello A, Lincot J, Schouman‑Claeys E, et al. Comparison of apparent diffusion coefficient in spondylarthritis axial active inflammatory lesions and type 1 Modic changes. Eur J Radiol. 2014;83:366–70.
  12. Belykh E, Kalinin AA, Patel AA, Miller EJ, Bohl MA, Stepanov IA, et al. Apparent diffusion coefficient maps in the assessment of surgical patients withlumbar spine degeneration. PLoS One. 2017;12:e0183697.
  13. LamKS, Webb JK. Discitis.Hosp Med 2004;65:280–6.
  14. Koh DM, Collins DJ. Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol 2007;188:162–63.
  15. Eguchi Y. Ohtori S., Yamashita M, et al. Diffusion Magnetic ResonanceImaging to Differentiate Degenerative From Infectious Endplate Abnormalities in the Lumbar Spine. SPINE 2011;36:E198–E202.
  16. Vredeveld T, Teitsma XM, Mert A, Van der Wurff P. Prevalence of modic changes in active duty military men with lumbar disk herniation who were scheduled for surgery. J ManipPhysiolTher. 2012; 35:622e628.
  17. Viswanathan VK, Shetty AP, Rajasekaran S. Modic changes-An evidence-based, narrative review on its pathophysiology, clinical significance and role in chronic low back pain. Journal of Clinical Orthopaedics and Trauma. 2020;11:761-69
  18. Herlin C, Kjaer P, Espeland A, et al. Modic changes-Their associations with low back pain and activity limitation: a systematic literature review and metaanalysis. PloS One. 2018;13: e0200677.
  19. Patel KB, Poplawski MM, Pawha PS, et al. Diffusion-weighted MRI- claw sign‖ improves differentiation of infectious from degenerative modic type 1 signal changes of the spine. American Journal of Neuroradiology. 2014;35:1647-52.
  20. Madhok R, Sachdeva P. Evaluation of apparent diffusion coefficient values in spinal tuberculosis by MRI. Journal of Clinical and Diagnostic Research: JCDR. 2016;10:TC19.
  21. Muñoz Montoya JE, Pérez Cataño C, Tapicha Cuellar AM, et al. Utility of the claw sign in spine magnetic nuclear resonance with diffusion to differentiate Modic type I changes for degenerative disease versus infection. J Spine Surg. 2018;4:616-23.
  22. Oztekin O, Calli C, Kitis O, Adibelli Z, Eren C, Apaydin M, Zileli M, Yurtseven T. Reliability of diffusion weighted MR imaging in differentiating degenerative and infectious end plate changes. Radiology and Oncology. 2010;44:97-102.
  23. Balasubramanya R, Selvarajan SK. Lumbar Spine Imaging. In: StatPearls. StatPearls Publishing, Treasure Island (FL); 2022. PMID: 31985974.
  24. Ledermann HP, Schweitzer ME, Morrison WB, Carrino JA. MR imaging findings in spinal infections: rules or myths? Radiology 2003; 228:506–14.
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