Vertebral neoplastic compression fractures: Assessment by dual‐phase chemical shift imaging

Abstract

Purpose:To compare normal vertebrae with vertebrae with neoplastic compression fractures by means of opposedphase (OP) and in-phase (IP) gradient-echo (GRE) imaging. Materials and Methods:On OP and IP T1-W GRE images (obtained at 1.5 T with the fast low-angle shot (FLASH) technique) of dual-phase chemical shift sequences, we compared the signal intensity ratios (SIRs) of normal and compression-fractured vertebrae in 108 patients. Dualphase chemical shift sequences were measured in three groups of vertebral bone marrow in terms of the relative SIR in OP and IP images: group 1: normal vertebrae (N ϭ 30 with 90 vertebrae); group 2: non-neoplastic compressionfractured vertebrae (N ϭ 58 with 73 vertebrae); and group 3: neoplastic compression-fractured vertebrae (N ϭ 20 with 27 vertebrae). The presence of compressed vertebrae was ascertained based on the consensus of two experienced radiologists. The mean SIRs among the three groups were compared by means of the Tukey-Kramer test. Results:The mean SIRs of the three groups (group 1: 0.46 Ϯ 0.14; group 2: 0.63 Ϯ 0.21; and group 3: 1.02 Ϯ 0.11) were significantly different according to the TukeyKramer test (P Ͻ 0.01). Conclusion:OP and IP T1-W GRE MRI of vertebral SI abnormalities can help predict the nature of compression fractures.

Musculoskeletal Tumors: How to Use Anatomic, Functional, and Metabolic MR Techniques

“…Proton chemical shift MR imaging has been suggested as a valuable addition to a standard MR imaging protocol for the study of the bone marrow in vivo (4,(13)(14)(15)(16). In the present article, chemical shift imaging refers to in-phase and opposedphased imaging (acquired with single or separate sequences) (17), although it 2) 20 seconds after contrast agent administration shows avid early arterial enhancement in the lesion, in keeping with its malignant nature.…”

Mri in Non-Traumatic Vertebral Collapse With Emphasis on in-Phase/Opposed-Phase and Diffusion-Weighted Imaging Sequences With Histopathological Correlation

“…Eito K et al (2004) [18] also found similar findings, he stated significant difference in SIR between benign and malignant fractures, but noted that some of the benign VCs did not suppress on the opposed-phase images. In the present study, we observed that post contrast enhancement were seen on both malignant and benign VCs; however, posterior element involvement enhancing epidural, pre-and para-vertebral masses were noted in higher percentage in malignant VCs.…”

“…Erly, Oh E.S. et al (2006), [16] David Disler et al (1997), [17] and Eito K et al (2004) [18] used similar cut-off value in their study.…”

Chemical shift MRI can aid in the diagnosis of indeterminate skeletal lesions of the spine

“…In chemical shift MRI, the presence of microscopic fat will result in signal loss on the opposedphase images when compared to the in-phase images within a voxel [8,9]. Hence, CSI has been utilized to identify microscopic fat within skeletal lesions with the aim to distinguish benign from malignant marrow replacement processes [10][11][12][13][14][15][16]. Most recently, Kohl and co-workers evaluated the accuracy of CSI in the diagnosis of indeterminate skeletal lesions of the pelvis.…”