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J Korean Soc Radiol. 2018 Oct;79(4):208-217. English. Original Article. https://doi.org/10.3348/jksr.2018.79.4.208
Jeong H , Jin W , Park YS , Yun SJ , Park SY , Park JS , Ryu KN .
Department of Radiology, Kyung Hee University Hospital at Gangdong, Seoul, Korea. jinooki@daum.net
Department of Radiology, College of Medicine, Kyung Hee University, Seoul, Korea.
Abstract

Purpose

To determine the reliability of edema grading of the psoas and paraspinal muscles on axial T2-weighted magnetic resonance (MR) image (T2WI) for the detection of lumbar transverse process (TP) fractures.

Materials and Methods

A retrospective review of lumbar spine MR images of 56 patients (mean age = 56.1 years, age range = 17–87 years, male:female = 28:28) was conducted by 2 radiologists. Based on the axial T2WI at the disc level, the paraspinal muscles were classified into 4 compartments and muscle edema (increased signal intensity on axial T2WI) grading performed for each quadrant.

Results

A total of 486 TPs (with fracture: 24, without fracture: 462) of 56 patients were evaluated. Muscle edema grade showed moderate correlation with the presence of TP fracture (ρ = 0.466). When the total score of muscle edema was 2.50, the receiver operating characteristic curve showed a sensitivity of 72.7% and a specificity of 90.7%. A higher edema grade had a significantly higher probability of concomitant TP fracture [any sided (total): odds ratio = 1.704 (95% confidence interval = 1.410–2.060)].

Conclusion

Edema grading of the psoas and paraspinal muscles on axial T2WI of lumbar spine can be helpful in the detection of TP fracture.

Copyright © 2019. Korean Association of Medical Journal Editors.