Discordance between magnetic resonance imagine and plain radiographs for determining the acuity of osteoporotic compression fractures

作者：Huang, Tianji; Xiong, Jian^*; Xue, Feng; Kou, Yuhui; Zhang, Sen; Buser, Zorica; Wang, Jeffrey C.; Lin, Weicheng; Zhang, Peixun

来源：International Journal of Clinical and Experimental Medicine, 2016, 9(9): 17412-17419.

• Plain radiographs
• MRI
• osteoporotic vertebral compression fracture
• appropriate level

Objective: To analyze the discordance between plain radiographs and Magnetic Resonance Imaging (MRI) in determining the acuity of osteoporotic compression fractures and to identify factors that may be associated with a higher discordance rate. Summary of Background Data: Few studies have described the differences between MRI and plain radiographs in determining the appropriate level of osteoporotic compression fractures. There has been only one article describing the factors that are related to the discordance between MRI and plain radiographs in diagnosing osteoporotic compression fractures. Methods: 185 patients with osteoporotic compression fractures at a single institution were identified. Two experienced surgeons and one experienced radiologist reviewed the osteoporotic vertebral fractures on the plain radiographs and MRI independently, and reached a consensus on the acuity of the fracture for both imaging studies. In order to identify factors that may be associated with a higher discordance rate, univariate analysis was tested by Chi-square test, t-test and Mann-Whitney U test, variables whose P <= 0.1 in the univariate analysis were tested in multivariate logistic regression analysis. Results: After comparing the numbers and levels of fresh osteoporotic vertebral fractures, the concordance rate between the two studies for the diagnosis was 67%, while the discordance rate was 33%. Patients with multiple acute vertebral fractures had a higher discordance rate (P=0.000), and patients with history of a previously healed vertebral fracture had a higher discordance rate (P=0.007). Gender, history of trauma, history of non-vertebral fracture, past vertebral augmentation surgery, and Cobb angle were not associated with a higher discordance rate. Conclusions: Because of the high discordance rate between MRI and plain radiographs, an MRI is crucial in the evaluation of the acuity of osteoporotic vertebral compression fractures. Patients with multiple level vertebral fractures and with previous vertebral fractures may be better evaluated with MRI studies.

• 出版日期2016
• 单位北京大学