Diagnostic Imaging of Spinal Disorders

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (16 December 2022) | Viewed by 25279

Special Issue Editor


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Guest Editor
Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
Interests: DE-CT; rheumatology; gout; spine; lumbar; fusion; low back pain
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Special Issue Information

Dear Colleagues,

Spinal disorders include many different pathologies, including but not limited to developmental anomalies, degenerative, neoplastic, metabolic, inflammatory, and infectious diseases. Therefore, imaging of the axial skeleton poses unique challenges; the selection of proper imaging techniques and application of imaging modalities needs special attention from physicians and technicians alike. Furthermore, imaging is rapidly evolving, including the many applications of artificial intelligence, modern MRI sequences and spectral CT imaging – to name only a few. Thus, a constant update on innovations and practical guidance for diagnostic applications is the aim of this Special Issue in Diagnostics. Here, we want to understand diagnostic decisions, derive treatment-guiding and prognostic information and assess treatment responses and complications. We want to uncover techniques that allow for more precise pathologies analysis and discover new imaging modalities for old diseases and novel applications of longstanding methods. The ultimate aim is to improve the diagnosis and care for our patients. This Special Issue of Diagnostics focuses on “Diagnostic Imaging of Spinal Disorders” and invites submissions on future possibilities, recent advances, emerging approaches and best up-to-date guidance for imaging the axial skeleton, i.e., the spine and sacroiliac joints. 

Dr. Torsten Diekhoff
Guest Editor

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Keywords

  • spine
  • sacroiliac joints
  • radiography
  • computed tomography
  • magnetic resonance imaging
  • nuclear medicine
  • artificial intelligence
  • radiomics

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Published Papers (5 papers)

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Research

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11 pages, 9838 KiB  
Article
Diagnostic Utility of Double-Echo Steady-State (DESS) MRI for Fracture and Bone Marrow Edema Detection in Adolescent Lumbar Spondylolysis
by Atsushi Kitakado, Takeshi Fukuda, Jiro Kobayashi and Hiroya Ojiri
Diagnostics 2023, 13(3), 461; https://doi.org/10.3390/diagnostics13030461 - 26 Jan 2023
Cited by 2 | Viewed by 3471
Abstract
To evaluate the ability of double-echo steady-state (DESS) MRI to detect pars interarticularis fracture and bone marrow edema (BME) in spondylolysis, 500 lumber pars interarticularis from 50 consecutive patients (38 males and 12 females, mean age 14.2 ± 3.28 years) with spondylolysis who [...] Read more.
To evaluate the ability of double-echo steady-state (DESS) MRI to detect pars interarticularis fracture and bone marrow edema (BME) in spondylolysis, 500 lumber pars interarticularis from 50 consecutive patients (38 males and 12 females, mean age 14.2 ± 3.28 years) with spondylolysis who underwent both MRI and CT within 1 week were evaluated. All participants were young athletes who complained of lower back pain. Fractures were classified into four grades and CT was used as a reference; BME was evaluated in a binary manner and STIR was used as a reference. The diagnostic performance of fractures on DESS and T1WI, and BME on DESS was assessed by two radiologists independently. For fracture detection, DESS showed high diagnostic performance at a sensitivity of 94%, specificity of 99.5%, and accuracy of 98.8%, whereas T1WI showed lower sensitivity (70.1%). Fracture grading performed by DESS showed excellent agreement with CT grading (Kappa = 0.9). For BME, the sensitivity, specificity, and accuracy of DESS were 96.5%, 100%, and 99.6%, respectively. The inter-rater agreement of DESS for fracture and BME was 0.8 and 0.85, respectively. However, the inter-rater agreement for fracture on T1WI was 0.52. DESS had high diagnostic performance for fracture and BME in pars interarticularis. In conclusion, DESS had potential to detect all critical imaging findings in spondylolysis and may replace the role of CT. Full article
(This article belongs to the Special Issue Diagnostic Imaging of Spinal Disorders)
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9 pages, 1170 KiB  
Article
Prediction of Target Epidural Blood Patch Treatment Efficacy in Spontaneous Intracranial Hypotension Using Follow-Up MRI
by Yu-Wei Wang, Chieh-Lin Jerry Teng, Jyh-Wen Chai, Chih-Cheng Wu, Po-Lin Chen and Hung-Chieh Chen
Diagnostics 2022, 12(5), 1158; https://doi.org/10.3390/diagnostics12051158 - 6 May 2022
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Abstract
Objectives: Epidural blood patching (EBP) is the mainstay therapy for spontaneous intracranial hypotension (SIH). MRI is used for evaluating spinal CSF leakage. Post-EBP MRI has been. shown to be effective in predicting the efficacy of EBP. However, there are few reports on how [...] Read more.
Objectives: Epidural blood patching (EBP) is the mainstay therapy for spontaneous intracranial hypotension (SIH). MRI is used for evaluating spinal CSF leakage. Post-EBP MRI has been. shown to be effective in predicting the efficacy of EBP. However, there are few reports on how post-EBP MRI findings may change with time. The aim of this study was to evaluate the relationship between post-EBP MRI findings at different time points and the corresponding effectiveness of EBP. Methods: We retrospectively reviewed 63 SIH patients who had received target EBP. All patients received an MRI follow-up within 10 days (post-EBP MRI) and at 3 months after EBP (3-month MRI). A sub-group analysis was performed at different post-EBP MRI time points (0–2, 3–6, and 7–10 days). The relationships between the post-EBP MRI findings and the EBP effectiveness were evaluated. Results: Thirty-five (55.56%) patients were assigned to the EBP-effective group, and 28 (44.44%) were assigned to the EBP non-effective group according to the 3-month MRI. Compared to the EBP non-effective group, the EBP-effective group had significantly lower numbers of spinal CSF leakage in the post-EBP MRI (4.49 vs. 11.71; p = 0.000) and greater numbers of leakage improvement (7.66 vs. 2.96; p = 0.003). For patients who received post-EBP MRI during periods of 0–10, 0–2, 3–6, and 7–10 days, the cutoff values of numbers of spinal CSF leakage for predicting EBP failure were 4, 6, 4, and 5, respectively, with an AUC above 0.77. Conclusion: By using post-EBP MRI, which only takes approximately 20 min, predicting EBP efficacy became possible in SIH patients. This study provides cutoff values of numbers of spinal CSF leakage at different follow-up times to serve as clues of if further EBP is needed, which provides the novelty of the current study. Full article
(This article belongs to the Special Issue Diagnostic Imaging of Spinal Disorders)
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Review

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13 pages, 1472 KiB  
Review
Sex Disparities of the Sacroiliac Joint: Focus on Joint Anatomy and Imaging Appearance
by Sevtap Tugce Ulas, Torsten Diekhoff and Katharina Ziegeler
Diagnostics 2023, 13(4), 642; https://doi.org/10.3390/diagnostics13040642 - 9 Feb 2023
Cited by 8 | Viewed by 2600
Abstract
The sacroiliac joint (SIJ) is an anatomically complex joint which, as a functional unit with the pelvis and spine, is of decisive biomechanical importance for the human body. It is also a commonly overlooked source of lower back pain. Like the entire bony [...] Read more.
The sacroiliac joint (SIJ) is an anatomically complex joint which, as a functional unit with the pelvis and spine, is of decisive biomechanical importance for the human body. It is also a commonly overlooked source of lower back pain. Like the entire bony pelvis, the SIJ exhibits major sexual dimorphisms; thus, the sex-dependent evaluation of this joint is becoming increasingly important in clinical practice, both anatomically with joint shape variations and biomechanical differences as well as in terms of image appearance. The influence of the SIJ shape, which differs in women and men, is crucial for the different biomechanical joint properties. These differences are important in the development of joint diseases at the SIJ, which shows a specific difference between the sexes. This article aims to provide an overview of sex disparities of the SIJ regarding different anatomical and imaging appearances to further understand the insights into the interplay of sex differences and SIJ disease. Full article
(This article belongs to the Special Issue Diagnostic Imaging of Spinal Disorders)
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14 pages, 5904 KiB  
Review
Imaging Characteristics of Diffuse Idiopathic Skeletal Hyperostosis: More Than Just Spinal Bony Bridges
by Iris Eshed
Diagnostics 2023, 13(3), 563; https://doi.org/10.3390/diagnostics13030563 - 3 Feb 2023
Cited by 10 | Viewed by 13254
Abstract
Diffuse idiopathic skeletal hyperostosis (DISH) is a systemic condition characterized by new bone formation and enthesopathies of the axial and peripheral skeleton. The pathogenesis of DISH is not well understood, and it is currently considered a non-inflammatory condition with an underlying metabolic derangement. [...] Read more.
Diffuse idiopathic skeletal hyperostosis (DISH) is a systemic condition characterized by new bone formation and enthesopathies of the axial and peripheral skeleton. The pathogenesis of DISH is not well understood, and it is currently considered a non-inflammatory condition with an underlying metabolic derangement. Currently, DISH diagnosis relies on the Resnick and Niwayama criteria, which encompass end-stage disease with an already ankylotic spine. Imaging characterization of the axial and peripheral skeleton in DISH subjects may potentially help identify earlier diagnostic criteria and provide further data for deciphering the general pathogenesis of DISH and new bone formation. In the current review, we aim to summarize and characterize axial and peripheral imaging findings of the skeleton related to DISH, along with their clinical and pathogenetic relevance. Full article
(This article belongs to the Special Issue Diagnostic Imaging of Spinal Disorders)
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Other

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7 pages, 1190 KiB  
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Spinal Schwannomatosis Mimicking Metastatic Extramedullary Spinal Tumor
by Idris Nurdillah, Iqbal Hussain Rizuana and Sharis Osman Syazarina
Diagnostics 2023, 13(7), 1254; https://doi.org/10.3390/diagnostics13071254 - 27 Mar 2023
Cited by 1 | Viewed by 2401
Abstract
Intradural extramedullary (IDEM) tumors are the most commonly observed intraspinal tumors, comprising over 60% of tumors found within the spinal canal, and the vast majority of these lesions are benign lesions. IDEM metastases are rare, but if they occur, they commonly manifest as [...] Read more.
Intradural extramedullary (IDEM) tumors are the most commonly observed intraspinal tumors, comprising over 60% of tumors found within the spinal canal, and the vast majority of these lesions are benign lesions. IDEM metastases are rare, but if they occur, they commonly manifest as leptomeningeal disease, secondary to drop lesions from intracranial metastases from adenocarcinomas of the lung, prostate cancer, breast cancer, melanoma, or rarely, as a result of lymphomas. The purely non-neurogenic origin of IDEM metastases is rare. Herein, we describe a patient with a previous history of treated colon cancer who presented with a progressive neurological deficit and whose imaging revealed multiple intradural, extramedullary and osseous lesions at the cervical and thoracolumbar spines. With the previous known primary and multiplicity of the lesions, an initial diagnosis of spinal metastasis was made, But it was proven to be schwannoma on histology. We emphasize the diagnostic dilemma in this case and the importance of detecting subtle imaging findings, which may be helpful to differentiate between metastatic disease and a second primary tumor. Full article
(This article belongs to the Special Issue Diagnostic Imaging of Spinal Disorders)
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