ABSTRACT
Objective: The objective of this study was to establish the cutoff value of the signal intensity drop on chemical shift magnetic resonance imaging [MRI] with appropriate sensitivity and specificity to differentiate osteoporotic from neoplastic wedging of the spine
Patients and Methods: All patients with wedging of vertebral bodies were included consecutively between February 2006 and January 2007. A chemical shift MRI was performed and signal intensities after [in-phase and out-of-phase] images were obtained. A DEXA was performed
Results: A total of 40 patients were included, 20 with osteoporotic wedging [group. 1] and 20 neoplastic [group.2]. They were 21 males and 19 females. On the chemical shift MRI a substantial reduction in signal intensity was found in all lesions in both groups. The proportional changes observed in signal intensity of bone marrow lesions on in-phase compared with out-of-phase images showed significant differences in both groups [p <0.05]. At a cut-off value of 35%, the observed sensitivity of out-of-phase images was 95%, specificity was 100%, positive predictive value was 100% and negative predictive value was 95.2%
Conclusion: A chemical shift MRI is useful in order to differentiate patients with vertebral collapse due to underlying osteoporosis or neoplastic process