Document Type : Research Paper
Diagnostic Imaging -Surgery Department, College of Medicine, University of Sulimani, Kurdistan Region-Iraq
Background and Objectives: Our prime objective is to evaluate the significant impact of MRI on the diagnosis of osseous spinal metastasis and secondly to be distinguished from other pathologies that may mimic spinal metastasis.
Method: This prospective cross section study was carried out in MRI department of both Diagnostic Imaging Center /Sulimani Teaching Hospital & Shahid Heman Teaching Hospital of Sulimani Governorate -Kurdistan Region -Iraq, from November 2016 until August 2017. A total number of 100 (54 male and 46 female) consecutive patients were involved. MRI examination was conducted by 1.5 Tesla MRI; Siemens (Magnetom Harmony Symphony Sonata Version) & Philips (Achieva 2007). The age of patients was ranging between (16-82 years) with mean age for spinal metastasis was (53.5 years). Tissue diagnosis was depended for the final diagnosis of spinal metastasis.
Results: The results revealed that spinal metastatic lesions were predominantly from CA breast & CA prostate accounting for (26 %) & (15 %) in female & male respectively, while other primary tumors include; bronchogenic carcinoma (10%), NHL in (7%), renal cell carcinoma in (4 %) and colonic cancer in (3%). The most frequent location of spinal metastasis was in a descending order, i.e. dorsal, lumbar, cervical and sacral were affected in rate of (68%, 26%, 4 % and 2%) respectively, with an incidence around (100%) for vertebral body metastases, followed by (32%) for pedicles, and only (2%) of laminae and cost vertebral junction. Ninety six percent or (96%) of patients had multiple vertebral involvement, (64%) of them were contagious, (10%) were non-contagious, (22%) were combined, while patterns of spinal metastatic lesions were osteolytic In (70%) of patients with spinal metastasis, osteosclerotic in (11%), and (19%) was mixed. Eighty (80%) out of 100 patients were of focal multiple patterns, while 15 patients (15%) showed diffuse bone marrow changes, and five patients (5%) had focal solitary pattern. Vertebral body collapse was seen in 34% of patients, while non showed intervertebral disc involvement even in infection cases.
Conclusion: It was concluded from the current study that the overall MRI accuracy for detection of spinal metastasis was 93%.