Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
European Spine Journal
Published in: European Spine Journal 1/2012

01-05-2012 | Original Article

Diffusion-weighted MR imaging in differentiation between osteoporotic and neoplastic vertebral fractures

Authors: G. Pozzi, C. Garcia Parra, P. Stradiotti, T. V. Tien, A. Luzzati, A. Zerbi

Published in: European Spine Journal | Special Issue 1/2012

Login to get access

Abstract

Purpose

To assess the usefulness of magnetic resonance imaging (MRI) with spin-echo echo-planar diffusion-weighted imaging (SE-EPI-DWI) in differentiation between vertebral osteoporotic fractures and pathological neoplastic fractures.

Materials and methods

Thirty-three patients with both osteoporotic or neoplastic vertebral fractures diagnosed with X-ray or TC were studied with MRI exam, (1.5 T unit) with DWI sequences. DWI sequences were qualitatively analyzed. Apparent diffusion coefficient (ADC) values were also determined and compared to the definitive histologic diagnosis.

Results

DWI of neoplastic lesions showed hyperintensity signal in 22 out of 23 cases. Mean ADC value of neoplastic fractures was 1.241 ± 0.4 × 10−3 mm2/s; mean ADC value of osteoporotic fractures was 0.646 ± 0.368 × 10−3 mm2/s. Neoplastic fractures showed ADC values significantly higher than osteoporotic ones (p < 0.001). DWI imaging and histology showed a significant correlation.

Conclusion

DWI provides reliable information to support MRI diagnosis of neoplastic versus osteoporotic fractures. ADC value appears as a useful adjunctive parameter.
Literature
1.
Malawer MM, Delaney T (1993) Treatment of metastatic cancer to bone. In: VTD, Vincent T, Hellman S et al (eds) Cancer: principle and practice of oncology. Lippincott, Philadelphia, pp 2225–2245
2.
Fornasier VL, Czitrom AA (1978) Collapsed vertebrae: a review of 659 autopsies. Clin Orthop Relat Res 131:261–265PubMed
3.
Ratanatharathorn V, Powers WE (1991) Epidural spinal cord compression from metastatic tumor: diagnosis and guidelines for management. Cancer Treat Rev 18(1):55–71PubMedCrossRef
4.
Frager D, Elkin C, Swerdlow M et al (1988) Subacute osteoporotic compression fracture: misleading magnetic resonance appearance. Skeletal Radiol 17(2):123–126PubMedCrossRef
5.
Yuh WT, Zachar CK, Barloon TJ et al (1989) Vertebral compression fractures: distinction between benign and malignant causes with MR imaging. Radiology 172(1):215–218PubMed
6.
An HS, Andreshak TG, Nguyen C et al (1995) Can we distinguish between benign versus malignant compression fractures of the spine by magnetic resonance imaging? Spine 20(16):1776–1782PubMedCrossRef
7.
Baker LL, Goodman SB, Perkash I et al (1990) Benign versus pathologic compression fractures of vertebral bodies: assessment with conventional spin-echo, chemical-shift, and STIR MR imaging. Radiology 174(2):495–502PubMed
8.
Palmer WE, Suri R, Kattapuram SV (1999) Benign versus malignant vertebral collapse: value of a fracture line on MR images. Radiology (Suppl):213–293
9.
Baur A, Stabler A, Arbogast S et al (2002) Acute osteoporotic and neoplastic vertebral compression fractures: fluid sign at MR imaging. Radiology 225(3):730–735PubMedCrossRef
10.
Tan SB, Kozak JA, Mawad ME (1991) The limitations of magnetic resonance imaging in the diagnosis of pathologic vertebral fractures. Spine 16(8):919–923PubMedCrossRef
11.
Rupp RE, Ebraheim NA, Coombs RJ (1995) Magnetic resonance imaging differentiation of compression spine fractures or vertebral lesions caused by osteoporosis or tumor. Spine 20(23):2499–2503 (discussion 2504)PubMedCrossRef
12.
Le Bihan DJ, Turner R (1992) Diffusion and perfusion. In: Stark DD, Bradley WG Jr (eds) Magnetic resonance imaging, 2nd edn. Mosby-Year Book, St Louis, pp 335–371
13.
Le Bihan D, Douek P, Argyropoulou M et al (1993) Diffusion and perfusion magnetic resonance imaging in brain tumors. Top Magn Reson Imaging 5(1):25–31PubMed
14.
Turner R, Le Bihan D, Maier J et al (1990) Echo-planar imaging of intravoxel incoherent motion. Radiology 177(2):407–414PubMed
15.
Bammer R, Fazekas F (2003) Diffusion imaging of the human spinal cord and the vertebral column. Top Magn Reson Imaging 14(6):461–476PubMedCrossRef
16.
Baur A, Stabler A, Bruning R et al (1998) Diffusion-weighted MR imaging of bone marrow: differentiation of benign versus pathologic compression fractures. Radiology 207(2):349–356PubMed
17.
Spuentrup E, Buecker A, Adam G et al (2001) Diffusion-weighted MR imaging for differentiation of benign fracture edema and tumor infiltration of the vertebral body. AJR Am J Roentgenol 176(2):351–358PubMed
18.
Stejskal EO, Tanner JE (1965) Spin diffusion measurements: spin echoes in the presence of a time-dependent field gradient. J Chem Phys 42(1):288–292CrossRef
19.
Baur A, Stäbler A, Brüning R et al (1998) Diffusion-weighted MR imaging of bone marrow: differentiation of benign versus pathologic compression fractures. Radiology 207(2):349–356PubMed
20.
Castillo M, Arbelaez A, Smith JK et al (2000) Diffusion-weighted MR imaging offers no advantage over routine noncontrast MR imaging in the detection of vertebral metastases. AJNR Am J Neuroradiol 21(5):948–953PubMed
21.
Spuentrup E, Bruecker A, Adam G et al (2001) Diffusion-weighted MR imaging for differentiation of benign fracture edema and tumor infiltration of the vertebral body. AJR Am J Roentgenol 176(2):351–358PubMed
22.
Baur A, Huber A, Dürr HK et al (2002) Differentiation of benign osteoporotic and neoplastic vertebral compression fractures with a diffusion-weighted, steady-state free precession sequence. Rofo 174(1):70–75PubMedCrossRef
23.
Abanoz R, Hakyemez B, Parlak M (2003) Diffusion-weighted imaging of acute vertebral compression: differential diagnosis of benign versus malignant pathologic fractures. Tani Girisim Radyol 9(2):176–183PubMed
24.
Hackländer T, Scharwächter C, Golz R et al (2006) Value of diffusion-weighted imaging for diagnosing vertebral metastases due to prostate cancer in comparison to other primary tumors. Rofo Fortschr Röntgenstr 178:416–424CrossRef
25.
Byun WM, Shin SO, Chang Y et al (2002) Diffusion-weighted MR imaging of metastatic disease of the spine: assessment of response to therapy. AJNR Am J Neuroradiol 23(6):906–912PubMed
26.
Dietrich O, Biffar A, Reiser MF et al (2009) Diffusion-weighted imaging of bone marrow. Semin Musculoskelet Radiol 13(2):134–144PubMedCrossRef
Metadata
Title
Diffusion-weighted MR imaging in differentiation between osteoporotic and neoplastic vertebral fractures
Authors
G. Pozzi
C. Garcia Parra
P. Stradiotti
T. V. Tien
A. Luzzati
A. Zerbi
Publication date
01-05-2012
Publisher
Springer-Verlag
Published in
European Spine Journal / Issue Special Issue 1/2012
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-012-2227-x

Other articles of this Special Issue 1/2012

European Spine Journal 1/2012 Go to the issue

Original Article

Treatment of kyphotic deformities in adults: our experience

Original Article

Lumbar spinal stenosis treatment with aperius perclid interspinous system

Original Article

Single level cervical fusion by an anterior approach using autologous bone graft influences the adjacent levels degenerative changes: clinical and radiographic results at 10-year minimum follow-up

Original Article

Direct lateral access lumbar and thoracolumbar fusion: preliminary results

Editorial

Spine surgery in Italy between neuro and ortho surgeons

Original Article

Bioactive electrospun scaffold for annulus fibrosus repair and regeneration