RT Journal Article
SR Electronic
T1 Diagnostic Value of Increased Diffusion Weighting of a Steady-state Free Precession Sequence for Differentiating Acute Benign Osteoporotic Fractures from Pathologic Vertebral Compression Fractures
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 366
OP 372
VO 22
IS 2
A1 Baur, Andrea
A1 Huber, Armin
A1 Ertl-Wagner, Birgit
A1 Dürr, Roland
A1 Zysk, Stefan
A1 Arbogast, Susanne
A1 Deimling, Michael
A1 Reiser, Maximilian
YR 2001
UL http://www.ajnr.org/content/22/2/366.abstract
AB BACKGROUND AND PURPOSE: Differentiating acute benign from neoplastic vertebral compression fractures can pose a problem in differential diagnosis on routine MR sequences, as signal changes can be quite similar. Our purpose was to assess the value of increasing the diffusion weighting of a diffusion-weighted steady-state free precession (SSFP) sequence for differentiating these two types of vertebral compression fractures.METHODS: Twenty-nine patients with 32 acute vertebral compression fractures caused by osteoporosis (n = 15) or malignancy (n = 17) were examined with a diffusion-weighted SSFP sequence, a T1-weighted spin-echo sequence, and a short-inversion-time inversion recovery sequence. The SSFP sequence was performed with increased diffusion weighting (δ = 0.6, 3.0, 6.0, and 9.0 ms). The signal intensities of the fractured vertebral bodies were rated on a five-point scale from markedly hypointense to markedly hyperintense relative to normal adjacent vertebral bodies. Quantitative analysis was performed by region-of-interest measurements and by calculating the bone marrow contrast ratio. Statistical analysis was performed with the Mann Whitney U test and Student's t test.RESULTS: At δ = 3 ms, the osteoporotic fractures yielded hypointense signal in seven cases, isointense signal in six, and hyperintense signal in two. The fractures showed a progressive signal loss with increased diffusion weighting, so that hypointensity was reached in all but one case. All metastatic fractures had hyperintense signal with δ = 3 and 6.0 ms. With δ = 9.0 ms, four fractures became isointense.CONCLUSION: Increasing diffusion weighting can reduce false-positive hyperintense osteoporotic fractures or make hypointensity more obvious in cases of osteoporotic fractures.