Vertebral body compression fracture: discriminating benign from malignant causes by diffusion-weighted MR imaging and apparent diffusion coefficient value

Wonglaksanapimon, S.; Chawalparit, O.; Khumpunnip, S.; Tritrakarn, S.-O.; Chiewvit, P.; Charnchaowanish, P.

Journal of the Medical Association of Thailand 95(1): 81-87

2012


ISSN/ISBN: 0125-2208
PMID: 22379746
Document Number: 16028
To evaluate the diagnostic performance of apparent diffusion coefficient (ADC) value in discriminating benign from malignant vertebral compression fracture. 22 symptomatic patients with compression fracture of vertebra referred for conventional MRI spines during January 2009-March 2010 underwent additional diffusion weighted MR techniques. Evaluation of diffusion weighted MR imaging and quantified ADC value from reconstructed ADC map were performed. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of apparent diffusion coefficient (ADC) value were calculated. A total of 39 vertebral fractures; 7 malignant compression fractures and 32 benign compression fractures were evaluated. The difference between ADC values of malignant, benign compression fracture and normal vertebrae were statistically significant (p < 0.0001). The accuracy, sensitivity and specificity were 89.7%, 85.7% and 90.6% respectively with the ADC threshold of 0.89 to discriminate malignancy. The ADC promises to be an effective implement for characterization of vertebral body compression fracture in differentiating benign and malignant compression fractures.

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Vertebral body compression fracture: discriminating benign from malignant causes by diffusion-weighted MR imaging and apparent diffusion coefficient value