Benign versus metastatic vertebral compression fractures: combined diffusion-weighted MRI and MR spectroscopy aids differentiation

Rumpel, H., Chong, Y., Porter, D. A. and Chan, L. L. (2013) Benign versus metastatic vertebral compression fractures: combined diffusion-weighted MRI and MR spectroscopy aids differentiation. European Radiology, 23(2), pp. 541-550. (doi: 10.1007/s00330-012-2620-1) (PMID:22903620)

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Abstract

Objectives: To determine the residual lipid fraction in fractured vertebrae by 1H MR spectroscopy (MRS) and its confounding effect on differentiating benign from metastatic compression fractures of the spine using apparent diffusion coefficient (ADC) obtained by diffusion-weighted read-out-segmented echo-planar imaging. Methods: Fifty-two patients presenting with back pain and/or vertebral compression fractures related to different degrees of acute trauma, osteoporosis or clinically known metastatic disease underwent imaging at 1.5 T using (a) single-voxel MRS for water and lipid compositions over the fractured vertebral marrow, and (b) DWI at b = 0 and 650 s/mm2 to compute the ADC values. Results: In 46 fractured vertebrae, the amount of lipid displaced was variable. In low-impact trauma, lipid was either displaced partially (ADC of 1.60 ± 0.20 × 10−3 mm2/s) or almost totally with a higher ADC (2.20 ± 0.27 × 10−3 mm2/s). In acute high-impact trauma, the lipid fraction was negligible, yet an intermediate ADC was observed. In tumour infiltration, ADC was also intermediate (1.22 ± 0.14 × 10−3 mm2/s) despite a negligible lipid fraction. The ROC curve yielded a diagnostic accuracy of 0.944. Conclusion: ADC-MRS analysis provides knowledge of the residual lipid fraction in fractured vertebrae that could aid in the differentiation between benign and metastatic vertebral fractures in low-impact trauma.

Item Type:Articles
Additional Information:This study was funded by SingHealth Grant Singapore.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Porter, Professor David
Authors: Rumpel, H., Chong, Y., Porter, D. A., and Chan, L. L.
College/School:College of Medical Veterinary and Life Sciences > School of Psychology & Neuroscience
Journal Name:European Radiology
Publisher:Springer
ISSN:0938-7994
ISSN (Online):1432-1084
Published Online:18 August 2012

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