Open Access Open Access  Restricted Access Subscription Access

ROLE OF MAGNETIC RESONANCE IMAGING IN DIFFERENTIATING BENIGN AND MALIGNANT CAUSES OF VERTEBRAL COLLAPSE

Gidugu Venkata Ramdas, Sumit Gupta, Raj Kumar Arion, Amit Mittal, Rikki Singal

Abstract


Aims and Objective: To study the role of Magnetic Resonance Imaging (MRI) as a non-invasive tool in differentiating benign and malignant causes of vertebral collapse. To analyse further differentiating MRI features of benign vertebral collapse between an osteoporotic, traumatic and infective etiology. To correlate the MRI findings with Histopathological examination and ascertain the specificity.

 

Material and Methods: The present study was carried in the Department of Neurosurgery and Radiodiagnosis, M.M Institute of Medical Sciences and Research, Mullana, Ambala. Forty patients presenting with pain and having a collapsed vertebra on X- ray examination were included in this study.

 

Results: Out of these 40 patients, 13 were osteoporotic, 12 traumatic, 15 infective and 10 were malignant. The ADC value based MRI assessment was in accurate in two cases where in one case with low ADC values (<1) diagnosed as malignant came out to be tubercular on histopathology while another case diagnosed as infective on MRI on the basis of high ADC values (>1) came out to be malignant on HPE and on further evaluation with chest CT and bronchoscopy primary was found in right lung.

 

Conclusion: It is an efficient investigation with 96% accuracy when based on the morphological characteristics of pedicle, body of collapsed vertebra, paravertebral soft tissue mass, and preservation of normal bone marrow. Thus, MRI is an accurate and sensitive modality for differentiating benign and malignant causes of vertebral collapse.

Keywords


Spine, MRI, Vertebra, Benign, Malignant, Trauma.

Full Text:

PDF

References


Abdel-Wanis ME, Solyman MTM, and Hasan NMA. (2011). “Sensitivity, specificity and accuracy of MRI for differentiating vertebral compression fractures caused by malignancy, osteoporosis and infections”, Journal of Orthopaedic Surgery, Vol.19(2), pp.145-150.

Ansari S, Rauniyar RK, Dhungel K, Sah PL, Chaudhary P, and Ahmed K et al. (2013). “MR evaluation of spinal tuberculosis”, Al Ameen J Med Sci, Vol.6(3), pp.219-225.

Bhugaloo AA, Abdullah BJJ, Siow YS, and Ng KH. (2006). “Diffusion Weighted MR imaging in acute vertebral compression fractures: differentiation between malignant and benign causes”, Biomed Imaging Interv J, Vol.2(2), p.e12.

Chan JMH, Peh WCG, Tsui EYK, Chau LF, Cheung KK, and Chan KR et al. (2002). “Acute vertebral body compression fractures : Discrimination between benign and malignant causes using apparent diffusion coefficients”, The British Journal of Radiology, Vol.75, pp.207-214.

Fu TS, Chen LH, Liao JC, Lai PL, Niu CC, and Chen WJ. (2004). “Magnetic Resonance Imaging Characteristics of Benign and Malignant Vertebral Fractures”, Chang Gung Med J, Vol.27, pp.808-815.

Lee CS, Yu JW, Chung SS, Suh YL, Ahn G, and Ahn JM. (2007). “Delayed Post-traumaticVertebral Collapse: MR Categorization and MR Pathology Correlation”, Asian Spine J, Vol.1, pp.32-37.

Maeda M, Sakuma H, Maeir SE, and Takeda K. (2003). “Quantitative Assessment of Diffusion Abnormalities in Benign and Malignant Vertebral Compression fractures by Line Scan Diffusion Weighted Imaging”, AJR, Vol.181, pp.1203-1209.

Mubarak F, and Akhtar MW. (2011). “Acute vertebral compression fracture: Differentiation of malignant and benign causes by diffusion weighted magnetic resonance imaging”, JPMA, Vol.61, pp.555-558.

Old JL, and Calvert M. (2004). “Vertebral compression fractures in the elderly”, Am FamPhysician, Vol.69, pp.111-116.

Palle L, Reddy MB, and Reddy KJ. (2010). “Role of magnetic resonance diffusion imaging and apparent diffusion coefficient values in the evaluation of spinal tuberculosis in Indian patients”, IJRI, Vol.20, pp.279-283.

Pongpornsup S, Wajanawichakorn P, and Danchaivijitr N. (2009). “Benign Versus Malignant Compression Fracture: A Diagnostic Accuracy of Magnetic Resonance Imaging”, J Med Assoc Thai, Vol.92, pp.64-72.

Vacaro AR, Shah SH, and Schweitzer ME. (1999). “MRI description of vertebral osteomyelitis, neoplasm and compression fracture”, Orthopedics, Vol.22, pp.67-73.


Refbacks

  • There are currently no refbacks.


Send mail to ijsss@ijsss.com with questions or comments about this web site. 

International Journal of Surgery and Surgical Sciences, All rights reserved.