title: Diffusion-weighted MR imaging in differentiation between osteoporotic and neoplastic vertebral fractures.
abstract: OBJECTIVE
  To assess the usefulness of magnetic resonance imaging (MRI) with spin-echo echo-planar diffusion-weighted imaging (SE-EPI-DWI) in differentiation between vertebral osteoporotic fractures and pathological neoplastic fractures.
  
  
  METHODS
  Thirty-three patients with both osteoporotic or neoplastic vertebral fractures diagnosed with X-ray or TC were studied with MRI exam, (1.5 T unit) with DWI sequences. DWI sequences were qualitatively analyzed. Apparent diffusion coefficient (ADC) values were also determined and compared to the definitive histologic diagnosis.
  
  
  RESULTS
  DWI of neoplastic lesions showed hyperintensity signal in 22 out of 23 cases. Mean ADC value of neoplastic fractures was 1.241 ± 0.4 × 10(-3) mm(2)/s; mean ADC value of osteoporotic fractures was 0.646 ± 0.368 × 10(-3) mm(2)/s. Neoplastic fractures showed ADC values significantly higher than osteoporotic ones (p < 0.001). DWI imaging and histology showed a significant correlation.
  
  
  CONCLUSIONS
  DWI provides reliable information to support MRI diagnosis of neoplastic versus osteoporotic fractures. ADC value appears as a useful adjunctive parameter.
authors.affiliation: IRCCS Istituto Ortopedico Galeazzi, via R. Galeazzi 3, Milan, Italy. graziapozzi@gmail.com
authors.forename: G
authors.initials: G
authors.lastname: Pozzi
authors.forename: C
authors.initials: C
authors.lastname: Garcia Parra
authors.forename: P
authors.initials: P
authors.lastname: Stradiotti
authors.forename: T V
authors.initials: TV
authors.lastname: Tien
authors.forename: A
authors.initials: A
authors.lastname: Luzzati
authors.forename: A
authors.initials: A
authors.lastname: Zerbi
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016103:Spinal Fractures / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology; D013125:Spinal Neoplasms / Q000150:complications*; D013904:Thoracic Vertebrae / Q000293:injuries* / Q000473:pathology