title: High-resolution imaging of the spine using multidetector-row computed tomography: differentiation between benign and malignant vertebral compression fractures.
abstract: OBJECTIVE
  The purpose of this study was to investigate the ability of high-resolution computed tomography (CT) images to distinguish between benign and malignant vertebral compression fractures.
  
  
  METHODS
  Computed tomography images of 45 benign compression fractures in 40 patients and 33 malignant compression fractures in 33 patients were evaluated. A 16-slice multidetector-row CT scanner was used for data acquisition, and axial images with a slice thickness of 1 mm and sagittal and coronal multiplanar reconstruction images with a slice thickness of 0.7 to 1 mm were used for interpretation.
  
  
  RESULTS
  The following findings were significantly more frequent in malignant fractures: destruction of the anterolateral and/or posterior cortex of the vertebral body, destruction of the cancellous bone of the vertebral body, destruction of the end plate, destruction of the pedicle, a paraspinal soft tissue mass, and an epidural mass. The extremely reliable signs of malignancy were destruction of the anterolateral and/or posterior cortex of vertebral body (100% accuracy) and destruction of the cancellous bone of the vertebral body (97.4% accuracy).
  
  
  CONCLUSIONS
  High-resolution CT can provide many useful signs for differentiating between benign and malignant vertebral compression fractures, and its diagnostic ability is sufficient for clinical use.
authors.affiliation: Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan. tkubota@koto.kpu-m.ac.jp
authors.forename: Takao
authors.initials: T
authors.lastname: Kubota
authors.forename: Kei
authors.initials: K
authors.lastname: Yamada
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Ito
authors.forename: Osamu
authors.initials: O
authors.lastname: Kizu
authors.forename: Tsunehiko
authors.initials: T
authors.lastname: Nishimura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007479:Iopamidol; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000209:etiology; D013125:Spinal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D007479:Iopamidol