The intravertebral cleft in benign vertebral compression fracture: the diagnostic performance of non-enhanced MRI and fat-suppressed contrast-enhanced MRI

• Published in: British journal of radiology Vol. 82; no. 984; pp. 976 - 981
• Main Authors: RYU, C -W, HAN, H, LEE, Y.-M, LIM, M.-K
• Format: Journal Article
• Language: English
• Published: London British Institute of Radiology 01.12.2009; The British Institute of Radiology
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Contrast Media; Epidemiologic Methods; Female; Fractures, Compression - etiology; Fractures, Compression - surgery; Humans; Injuries of the limb. Injuries of the spine; Investigative techniques, diagnostic techniques (general aspects); Lumbar Vertebrae - pathology; Magnetic Resonance Imaging - methods; Male; Medical sciences; Middle Aged; Observer Variation; Osteoarticular system. Muscles; Osteoporosis - complications; Osteoporosis - diagnosis; Preoperative Care - methods; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Spinal Fractures - etiology; Spinal Fractures - surgery; Traumas. Diseases due to physical agents; Vertebroplasty - methods; Performance evaluation; Human; Compression; Stomatology; Diseases of the osteoarticular system; Fat signal; Vertebra; Congenital cleft; Fracture; Vertebroplasty; Congenital disease; Trauma; Nuclear magnetic resonance imaging; Percutaneous route; Malformation; Interindividual comparison; Medical imagery; Diagnosis; Technique; Comparative study
• ISSN: 0007-1285; 1748-880X
• DOI: 10.1259/bjr/57527063

We compared the diagnostic performance of non-enhanced MRI and fat-suppressed contrast-enhanced MRI (CEMRI) in diagnosing intravertebral clefts in benign vertebral compression fractures (VCFs). We retrospectively reviewed 99 consecutive patients who had undergone percutaneous vertebroplasty for VCFs. A cleft was defined as a signal void or hyperintense area on non-enhanced MRI (T(1) and T(2) weighted imaging) or as a hypointense area within a diffusely enhanced vertebra on CEMRI. A cleft was confirmed as a solid opacification on post-procedural radiographs. The interobserver reliability and MRI diagnostic performance were evaluated. The interobserver reliability of non-enhanced MRI was substantial (k _ 0.698) and the interobserver reliability of CEMRI was almost perfect (k _ 0.836). Post-procedural radiographs showed solid cleft opacification in 32 out of the 99 cases. The sensitivity and specificity of non-enhanced MRI were 0.72 and 0.82 (observer 1) and 0.63 and 0.87 (observer 2), respectively. The sensitivity and specificity of CEMRI were 0.94 and 0.63 (observer 1) and 0.85 and 0.60 (observer 2), respectively. The sensitivity of CEMRI was significantly higher than that of non-enhanced MRI, and the specificity of non-enhanced MRI was higher than that of CEMRI. CEMRI was highly reliable and sensitive, and non-enhanced MRI was specific for intravertebral clefts. Therefore, spine MRIs, including CEMRI, could provide useful information about intravertebral clefts before percutaneous vertebroplasty.