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Diffusion-weighted MR imaging in differentiation between osteoporotic and neoplastic vertebral fractures
G Pozzi1, C Garcia Parra, P Stradiotti
1IRCCS Istituto Ortopedico Galeazzi, via R. Galeazzi 3, Milan, Italy. graziapozzi@gmail.com
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) mm(2)/s; mean ADC value of osteoporotic fractures was 0.646 ± 0.368 × 10(-3) mm(2)/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.
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