Diffusion-weighted imaging of the spinal column

Diffusion-weighted imaging (DWI) of the spine provides a new method to study bone marrow and bone marrow alterations dynamically. Acute benign osteoporotic vertebral compression fractures and malignant vertebral compression fractures can be well differentiated with diffusion-weighted MR methods. Diagnosis is based on the contrast to normal bone marrow. Hypo-or iso-intensity reflects acute benign collapse, whereas hyperintensity is indicative of the tumorous nature of a fracture. A comparison of various diffusion-weighted methods, especially for the spine, should be performed to better understand image contrast and to optimize the sequence protocols. Future applications for DWI of the spine include the study of intervertebral discs, bone marrow edema, spondylodiskitis, and diffuse bone marrow alterations.