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Diffusion-weighted imaging of acute vertebral compression: Differential diagnosis of benign versus malignant pathologic fractures

Abanoz, Recep ; Hakyemez, Bahattin ; Parlak, Müfit

Tanisal ve girisimsel radyoloji, 2003-06, Vol.9 (2), p.176-183

Turkey

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  • Título:
    Diffusion-weighted imaging of acute vertebral compression: Differential diagnosis of benign versus malignant pathologic fractures
  • Autor: Abanoz, Recep ; Hakyemez, Bahattin ; Parlak, Müfit
  • Assuntos: Adult ; Aged ; Aged, 80 and over ; Bone Marrow - pathology ; Diagnosis, Differential ; Female ; Fractures, Spontaneous - pathology ; Humans ; Injury Severity Score ; Magnetic Resonance Imaging - methods ; Male ; Middle Aged ; Predictive Value of Tests ; Severity of Illness Index ; Spinal Fractures - pathology
  • É parte de: Tanisal ve girisimsel radyoloji, 2003-06, Vol.9 (2), p.176-183
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
    content type line 23
  • Descrição: Our purpose was to assess the value of diffusion-weighted steady-state free precession (SSFP) sequence for differentiating between benign and pathologic compression fractures. Forty-nine patients with 63 acute vertebral compression fractures caused by osteoporosis (n = 23), trauma (n = 7), malignancy (n = 30), infection (n = 3) were examined with a diffusion-weighted SSFP sequence (diffusion gradient strength; 23 mT/m, diffusion pulse length 5 ms), T1-weighted turbo spin-echo sequence, and short-inversion-time (TI 150 ms) T2-weighted turbo inversion recovery sequence. The signal intensity characteristics were analyzed qualitatively and quantitatively for all sequences. Statistical analysis was performed with the Student's t test. In diffusion-weighted MR imaging, benign osteoporotic and traumatic fractures were hypo- to isointense to adjacent normal vertebral bodies. Pathologic and infectious compression fractures were hyperintense to normal vertebral bodies. Pathologic vertebral fractures had positive bone marrow contrast ratios at diffusion-weighted imaging, whereas non infectious benign vertebral fractures had negative values (p < 0.001). The difference in bone marrow contrast ratios for benign and pathologic compression fractures at T1-weighted TSE and T2-weighted turbo IR was not significant (p > 0.01). Diffusion-weighted SSFP sequence provides unique information that significantly impacts the accuracy of radiologic diagnosis. Diffusion-weighted SSFP sequence may allow the differentiation of acute benign osteoporotic fractures from malignant compression fractures. Acute benign osteoporotic or traumatic fractures show hypointense or isointense signal on diffusion-weighted sequences that reflects persistent free water proton mobility. Malignant compression fractures show hyperintensity compared with normal surrounding bone marrow probably due to altered water proton mobility within the neoplasm.
  • Editor: Turkey
  • Idioma: Turco
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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