Are Non-Contrast MR Images Enough for Detection of Fracture Levels Prior to Percutaneous Vertebroplasty in Patients with Osteoporosis?

Yuan, Wei; Teng, Michael Mu Huo; Hsu, Hui Chen; Sun, Ying Chou; Chang, Cheng Yen

doi:10.1177/15910199080140s214

Cited by 3 publications

(2 citation statements)

References 8 publications

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“…Since the late 1990s, the efficacy of STIR sequence MR imaging has been recognized, with sensitivity and specificity rates exceeding 94% and both positive and negative predictive values over 90% for diagnosing fractures due to osteoporosis [ 6 , 7 , 8 , 20 ]. This high accuracy underpins its critical role in cases where lateral cervical CT scans fail to show abnormalities.…”

Section: Discussionmentioning

confidence: 99%

From Detection to Decision: How STIR Sequence MRI Influences Treatment Strategies for Osteoporotic Vertebral Fractures

Viola,

Aslan,

Al-Smadi

et al. 2024

JCM

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Background/Objectives: Osteoporotic vertebral fractures (OVFs) significantly impair quality of life. This study evaluates the impact of STIR sequence MR imaging on clinical decision-making for treating OVFs, mainly focusing on how MRI findings influence treatment modifications compared to those based solely on CT scans. Methods: This retrospective analysis reviewed cases from the Manninger Jenő National Traumatology Institute over ten years, where patients with suspected OVFs underwent CT and STIR sequence MR imaging. The study examined changes in treatment plans initiated by MRI findings. The diagnostic effectiveness of MRI was compared against CT in terms of sensitivity, specificity, and the ability to influence clinical treatment paths. Results: MRI detected 1.65 times more fractures than CT scans. MRI influenced treatment adjustments in 67% of cases, leading to significant changes from conservative–conservative, conservative–surgery, and surgery–surgery based on fracture characterizations provided by MRI. Conclusions: This study demonstrates that integrating STIR sequence MR imaging into the diagnostic pathway for OVFs significantly enhances the accuracy of fracture detection and profoundly impacts treatment decisions. The ability of MRI to reveal specific fracture features that are not detectable by CT scans supports its importance in the clinical evaluation of OVFs, suggesting that MRI should be incorporated more into diagnostic protocols to improve patient management and outcomes. The findings advocate for further research to establish STIR MRI as a standard osteoporosis management tool and explore its long-term benefits in preventing secondary fractures.

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Section: Discussionmentioning

confidence: 99%

From Detection to Decision: How STIR Sequence MRI Influences Treatment Strategies for Osteoporotic Vertebral Fractures

Viola,

Aslan,

Al-Smadi

et al. 2024

JCM

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show abstract

“…In the late 1990s and around the turn of the century, it was already established that the sensitivity and specificity of STIR sequence MR imaging exceeded 94% [6][7][8]. The positive and negative predictive values were over 90% for diagnosing fractures resulting from osteoporosis [20].…”

Section: Discussionmentioning

confidence: 99%

Enhancing Osteoporotic Vertebral Fracture Diagnosis and Treatment Planning: Comparing CT and STIR Sequence MRI

Viola,

Aslan,

Al-Smadi

et al. 2023

Preprint

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In response to a threefold increase in osteoporotic vertebral fractures (OVF) at our institution over the past decade and the subsequent development of new fractures within a year in a third of cases, we evaluated the effectiveness of STIR MRI scans in conjunction with CT scans for initial OVF diagnosis. This study, conducted over five months, involved full spine sagittal STIR MRI scans alongside CT scans for patients over 50 with minor injury-related vertebral fractures. The independent assessments by radiologists and neurosurgeons of 64 patients revealed that while CT scans identified 161 fresh fractures, of which only 68 were previously reported, MRI detected 266 fractures, 1.65 times more than CT. CT scans showed single fractures in 27% of patients and multiple fractures in 73%, whereas MRI identified single fractures in 9% and multiple fractures in 91% of patients. Additionally, MRI demonstrated a 1.5-fold increase in adjacent fracture detection. The use of MRI influenced treatment plans in 67% of cases. Given these findings, we advocate for including a STIR MRI of the entire spine alongside CT scans in OVF cases, as it significantly enhances fracture detection and can alter treatment strategies.

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Value of MRI in assessing back pain after thoracolumbar osteoporotic vertebral compression fractures and discussion on the underlying mechanisms by tissue biopsy

Sun

et al. 2022

Eur Spine J

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Are Non-Contrast MR Images Enough for Detection of Fracture Levels Prior to Percutaneous Vertebroplasty in Patients with Osteoporosis?

Cited by 3 publications

References 8 publications

From Detection to Decision: How STIR Sequence MRI Influences Treatment Strategies for Osteoporotic Vertebral Fractures

From Detection to Decision: How STIR Sequence MRI Influences Treatment Strategies for Osteoporotic Vertebral Fractures

Enhancing Osteoporotic Vertebral Fracture Diagnosis and Treatment Planning: Comparing CT and STIR Sequence MRI

Value of MRI in assessing back pain after thoracolumbar osteoporotic vertebral compression fractures and discussion on the underlying mechanisms by tissue biopsy

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