Rupak Dutta FRCR, Presenter: Nothing to Disclose

Vasu Keshav Sharma MBBS, FRCR, Abstract Co-Author: Nothing to Disclose

Krishna Mohan Gummalla DMRD, Abstract Co-Author: Nothing to Disclose

Matthew George FRCR, MMed, Abstract Co-Author: Nothing to Disclose

Objectives: 1. Identifying benign from pathological fractures based on morphology.                     2. DWI has high sensitivity with high PPV.                     3 Signal intensity ratio (SIR) of STIR with in/opposed phase.

Ascertaining the cause of vertebral collapse in patients with no known malignancy is of paramount importance since it is a predictor of prognosis and outcome. Osteoporotic compression may be indistinguishable from malignant collapse. Vertebral fractures may be detected on radiographs, CT or nucleutide studies but so often is unable to distinguish between benign versus malignant collapse. A retrospective of the MRI spines with acute vertebral collapse from 2008 to2013. MR features of malignant vertebral collapse includes multiple vertebral involvement, signal intensity, Gad enhancement, posterior cortex margins, paraspinal soft tissues, posterior element , DWI/ ADC, Chemical shift ( dual echo). MRI has a sensitivity of 100 % and specificity of 64 %. DWI has 92% sensitivity , 90% specificity and 85 % accuracy in differentiating benign from malignant. PPV and NPV values of approx 78 and 90 % respectively. Close follow up/ PET scan and also bone biopsy had to be resorted to in the remaining patients with indeterminate causes.

http://abstract.rsna.org/uploads/2014/14002578/14002578_n917.pdf

Dutta, R, Sharma, V, Gummalla, K, George, M, Differentiating Benign versus Pathological Vertebral Compression Fractures in the Osteoporotic Spines: Causes and Concerns.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14002578.html