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J Korean Soc Radiol. 2018 Oct;79(4):208-217. English. Original Article.
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.
Department of Radiology, College of Medicine, Kyung Hee University, Seoul, Korea.


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.


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)].


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.