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Multiple MRI techniques in the diagnosis and differentiation of primary osteoporotic vertebral compression fracture and pathologic fracture

LI Yong gang,WANG Ren fa,ZHANG Jing feng,et al.Department of Radiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,P.R.China  
Objective:To study multiple MRI techniques in differentiation of primary osteoporotic vertebral compression fracture and pathologic fracture.Methods:MRI was performed in 14 cases with primary osteoporotic vertebral compression fracture and 20 cases metastatic vertebral compression fracture.The following sequences were used:SE T 1WI,FSE T 2WI,STIR,DWI and enhanced SE T 1WI with fat suppression.The abnormal signal of vertebrae on different MRI sequences was analyzed, enhancement ratios,ADC values and bone marrow contrast ratios of lesions were calculated and statistic analysis was done.Results:The incidence rate of transverse laminar signal,retropulsion of postero superior corner of the vertebral and increased sagittal diameter of vertebrae,the abnormal signal in vertebral appendages,high signal in intervertebral disc,the invasion of soft tissue and vertebral canal demonstrated great difference between two groups.There was no difference of ADC values in two groups ( P 0.05),but the difference in enhancement ratio and bone marrow contrast ratio at DWI was significant ( P 0.01).Conclusion:The combined use of the multiple MRI sequences is very helpful in differentiation of primary osteoporotic vertebral compression fracture and pathologic fracture.
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