[Translated article] Diagnostic imaging in patients with vertebral compression fractures

Area of Science:

• Radiology
• Oncology
• Orthopedics

Background:

• Osteoporotic vertebral fractures (OVF) and metastatic vertebral fractures (MVF) often affect similar age groups, posing diagnostic challenges.
• Radiography is a common initial imaging modality but lacks sensitivity for detecting demineralization and soft tissue abnormalities.
• Accurate differentiation is crucial for appropriate patient management and treatment strategies.

Purpose of the Study:

• To evaluate the diagnostic utility of Magnetic Resonance Imaging (MRI) in differentiating OVF from MVF.
• To identify key MRI findings indicative of each fracture type.
• To assess the reproducibility of these diagnostic signs in clinical practice.

Main Methods:

• Review of vertebral fracture cases diagnosed via MRI.
• Analysis of specific MRI sequences and findings, including intravertebral signal changes, edema, and soft tissue masses.
• Comparison of MRI findings between confirmed OVF and MVF cohorts.
• Assessment of the inter-observer reliability for key diagnostic features.

Main Results:

• MRI is the preferred imaging modality for evaluating vertebral compression fractures.
• Key indicators for OVF include intravertebral fluid signal, vertebral deformities without edema, and older fracture age.
• Significant predictors for MVF include the presence of a soft tissue mass and asymmetry in pedicle signal intensity.
• The reproducibility of these diagnostic findings in routine clinical practice was found to be moderate.

Conclusions:

• MRI provides valuable criteria for distinguishing between osteoporotic and metastatic vertebral compression fractures.
• While specific MRI signs are suggestive, their moderate reproducibility necessitates careful interpretation.
• Further research may be needed to enhance the reliability of MRI in differentiating these conditions.