Diagnostic accuracy of 3-T magnetic resonance imaging with 3D T1 VIBE versus computer tomography in pars stress fracture of the lumbar spine.
OBJECTIVE
To compare the diagnostic accuracy of 3-T magnetic resonance imaging (MRI) with thin-slice 3D T1 VIBE sequence to 128-slice computer tomography (CT) in pars stress fractures of the lumbar spine.


METHODS
3-T MRI and CT of 24 patients involving 70 pars interarticularis were retrospectively reviewed by four blinded radiologists. The fracture morphology (complete, incomplete, or normal) was assessed on MRI and CT at different time points. Pars interarticularis bone marrow edema (present or absent) was also evaluated on MRI.


RESULTS
In total, 14 complete fractures, 31 incomplete fractures and 25 normal pars were detected by CT. Bone marrow edema was seen in seven of the complete and 25 of the incomplete fractures. The overall sensitivity, specificity and accuracy of MRI in detecting fractures (complete and incomplete) were 97.7, 92.3, and 95.7 %, respectively. MRI was 100 % accurate in detecting complete fractures. For incomplete fractures, the sensitivity, specificity, and accuracy of MRI were 96.7, 92.0, and 94.6 %, respectively.


CONCLUSIONS
3-T MRI with thin-slice 3D T1 VIBE is 100 % accurate in diagnosing complete pars fractures and has excellent diagnostic ability in the detection and characterization of incomplete pars stress fractures compared to CT. MRI has the added advantages of detecting bone marrow edema and does not employ ionizing radiation.
Victoria House Medical Imaging, 316 Malvern Road, Prahran, Victoria, Australia.
E C
EC
Ang
Victoria House Medical Imaging, 316 Malvern Road, Prahran, Victoria, Australia.
A F
AF
Robertson
Victoria House Medical Imaging, 316 Malvern Road, Prahran, Victoria, Australia.
F A
FA
Malara
Victoria House Medical Imaging, 316 Malvern Road, Prahran, Victoria, Australia.
T
T
O'Shea
Victoria House Medical Imaging, 316 Malvern Road, Prahran, Victoria, Australia.
J K
JK
Roebert
Monash Biomedicine Discovery Institute, Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia.
M E
ME
Schneider
Victoria House Medical Imaging, 316 Malvern Road, Prahran, Victoria, Australia. andrew.rotstein@i-med.com.au.
A H
AH
Rotstein
D000293:Adolescent; D000328:Adult; D001855:Bone Marrow Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D015775:Fractures, Stress / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000293:injuries*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013122:Spinal Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D016103:Spinal Fractures / Q000150:complications / Q000000981:diagnostic imaging*; D055815:Young Adult
3-T MRI; Lumbar spine; Pars stress fracture; Pars stress reaction; Three-dimensional T1 VIBE