Prevalence of thoracolumbar vertebral fractures on multidetector CT: underreporting by radiologists.
OBJECTIVE
To evaluate the prevalence of osteoporotic vertebral fractures in patients undergoing multidetector computed tomography (MDCT) of the chest and/or abdomen.


METHODS
323 consecutive patients (196 males, 127 females) with a mean age of 62.6 years (range 20-88) who had undergone chest and/or abdominal MDCT were evaluated. Sagittal reformats of the spine obtained from thin section datasets were reviewed by two radiologists and assessed for vertebral fractures. Morphometric analysis using electronic calipers was performed on vertebral bodies which appeared abnormal upon visual inspection. A vertebral body height loss of 15% or more was considered a fracture and graded as mild (15-24%), moderate (25-49%) or severe (more than 50%). Official radiology reports were reviewed and whether the vertebral fractures had been reported or not was noted.


RESULTS
31 out of 323 patients (9.5%) had at least 1 vertebral fracture and 7 of those patients had multiple fractures for a total of 41 fractures. Morphometric grading revealed 10 mild, 16 moderate and 15 severe fractures. Prevalence was higher in women (14.1%) than men (6.6%) and increased with patients age with a 17.1% prevalence in post-menopausal women. Only 6 out 41 vertebral fractures (14.6%) had been noted in the radiology final report while the remaining 35 (85.45) had not.


CONCLUSIONS
although vertebral fractures represent frequent incidental findings on multidetector CT studies and may be easily identified on sagittal reformats, they are often underreported by radiologists, most likely because of unawareness of their clinical importance.
Bartalena
Tommaso
T
Department of Radiology, S. Orsola University Hospital, Via Massarenti 9-40138 Bologna, Italy. t.bartalena@email.it
Giannelli
Giovanni
G
Rinaldi
Maria Francesca
MF
Rimondi
Eugenio
E
Rinaldi
Giovanni
G
Sverzellati
Nicola
N
Gavelli
Giampaolo
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015995:Prevalence; D011361:Professional Competence; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging* / Q000293:injuries*; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D055815:Young Adult