Differentiation of Osteoporotic Fracture from Metastatic Fracture in Spine using MRI

Yang, Jun Young; Lee, June Kyu; Lee, Ho Jin; Park, Jun Yeong; Shin, Byungkon

Abstract

OBJECTIVES
To determine that compression fracture of L5 and posterior convexity of the vertebral body on MRI are useful indicators of spinal metastasis.
MATERIALS AND METHODS
Forty seven cases of vertebral compression fractures with magnetic resonance imaging (MRI) were reviewed. They were classified into two groups: the metastatic fracture (MF) group (n=23) and the osteoporotic fracture (OF) group (n=24). Each cases were evaluated according to their MRI findings of fracture site location, and the presence of posterior convexity of the vertebral body, intact midseptum and anterior signal change. Conventional T1 and T2 weighted images were obtained. Statistical analysis was done using the paired t-test and fisher's exact test.
RESULTS
The MF group had 100% incidence of fracture in L5 (P<0.01). The incidence of positive posterior convexity was also 100%. The incidence of a positive anterior signal change was 67% (n=16) and intact septum was seen in 16 patients (67%). In the OF group, there were no fractures in L5 (16 cases with L1 fractures [67%]) and only 3 cases with posterior convexity (12.5%). Midseptum was intact in 19 cases (79%) and 6 patients with positive anterior signal change (25%).
CONCLUSIONS
The location of vertebral fracture, especially in L5 and convex deformity of posterior vertebral body are reliable indicators of spinal metastasis.