Whole spine localizers of magnetic resonance imaging detect unexpected vertebral fractures. (June 2019)

• Record Type: Journal Article
• Authors: Kaniewska, Malwina; de Beus, Johannes Maria; Ahlhelm, Frank; Mameghani, Alexander; Eid, Karim; Kubik-Huch, Rahel A; Anderson, Suzanne E
• Is Part Of: Acta radiologica. Volume 60:Number 6(2019)
• Page Start: 742
• Page End: 748
• Publication Date: 2019-06
• Subjects: Spinal fracture -- magnetic resonance imaging -- MRI -- aged -- osteoporotic fractures/diagnosis; Radiology, Medical -- Periodicals; Radiography, Medical -- Periodicals; Radiotherapy -- Periodicals; 616.0757
• DOI: 10.1177/0284185118796673
• Languages: English
• ISSNs: 0284-1851

Abstract

Background: Whole spine localizers (WS-loc) of magnetic resonance imaging (MRI) are performed for enumeration of the vertebrae but they can be also used for the evaluation of the spine. Purpose: To assess the accuracy of fracture detection using WS-locs of MRI and compare the findings with standard high-resolution short tau inversion recovery (STIR) sequences, and to determine whether the review of WS-locs is useful and if additional information can be gained by assessing the thoracic spine section of the WS-locs. Material and Methods: A total of 298 magnetic resonance (MR) examinations of the lumbar spine with WS-locs were evaluated. Two independent readers reviewed the images. In case of fracture detection, further characterization of the fracture was performed. To assess inter-reader agreement, unweighted Cohen's kappa with 95% confidence intervals (CI) and Phi coefficients were calculated. Results: The study sample included 187 female and 111 male patients (age range = 65–94 years; median age = 75.0 years). The WS-locs detected 42 fractures of the lumbar spine and 36 of the thoracic spine. Inter-reader agreement for fracture detection in the lumbar and thoracic spine was strong (K = 0.87, 95% CI = 0.78–0.95, Phi = 0.87, and K = 0.88, 95% CI = 0.79–0.96, Phi = 0.88, respectively). Conclusion: WS-locs from MR examinations of the lumbar spine provide a good diagnostic tool for the detection and evaluation of unsuspected vertebral fractures. WS-locs show strong inter-reader agreement for fracture detection in the thoracic and lumbar spine.