title: Evaluation of sclerosis in Modic changes of the spine using susceptibility-weighted magnetic resonance imaging.
abstract: OBJECTIVE
  To evaluate the diagnostic performance of susceptibility-weighted magnetic resonance imaging (SWMR) for the differentiation of sclerotic and non-sclerotic Modic changes (MC) of the spine compared to computed tomography (CT) and radiographs.
  
  
  METHODS
  The Institutional Ethics-Review-Board approved this prospective study in advance. Written consent was obtained from all subjects. SWMR and standard T1/T2 MR of the cervical (n=21) and/or lumbar spine (n=34) were performed in 54 patients. 21 patients served as control. 18 patients were evaluated with CT; in all other patients radiographs were available. 67 Modic changes were identified on T1/T2 MR. On SWMR changes were classified as sclerotic and non-sclerotic based on signal intensity measurements. The sensitivity and specificity of SWMR and T1/T2 MR for differentiating between sclerotic and non-sclerotic Modic changes were determined with CT and radiographs as reference standard.
  
  
  RESULTS
  On SWMR, signal measurements between sclerotic and non-sclerotic Modic changes differed significantly (p<0.01). On T1- and T2-weighted MR no significant difference (p>0.05) was measured. On SWMR, a reliable differentiation between sclerotic and non-sclerotic Modic changes could be achieved, with a sensitivity of 100% and specificity of 95%. In contrast, the combination of T1-/T2-weighted MR yielded a significantly lower sensitivity to detect sclerosis (20%).
  
  
  CONCLUSIONS
  SWMR allows a reliable detection of sclerosis in Modic changes with a higher accuracy compared to standard spine MR sequences, using radiographs and CT as reference standard.
authors.affiliation: Department of Radiology, Charité, Charitéplatz 1, 10117 Berlin, Germany. Electronic address: Sarah-maria.boeker@charite.de.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Böker
authors.affiliation: Department of Radiology, Charité, Charitéplatz 1, 10117 Berlin, Germany. Electronic address: Yi-na.bender@charite.de.
authors.forename: Yvonne Y
authors.initials: YY
authors.lastname: Bender
authors.affiliation: Department of Radiology, Charité, Charitéplatz 1, 10117 Berlin, Germany. Electronic address: Lisa.adams@charite.de.
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Adams
authors.affiliation: Department of Radiology, Charité, Augustenburger Platz 1, 13353 Berlin, Germany. Electronic address: Eva.fallenberg@charite.de.
authors.forename: Eva M
authors.initials: EM
authors.lastname: Fallenberg
authors.affiliation: Department of Radiology, Charité, Charitéplatz 1, 10117 Berlin, Germany. Electronic address: Moritz.wagner@charite.de.
authors.forename: Moritz
authors.initials: M
authors.lastname: Wagner
authors.affiliation: Department of Radiology, Charité, Charitéplatz 1, 10117 Berlin, Germany. Electronic address: Bernd.hamm@charite.de.
authors.forename: Bernd
authors.initials: B
authors.lastname: Hamm
authors.affiliation: Department of Radiology, Charité, Charitéplatz 1, 10117 Berlin, Germany. Electronic address: Marcus.makowski@charite.de.
authors.forename: Marcus R
authors.initials: MR
authors.lastname: Makowski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012598:Sclerosis / Q000000981:diagnostic imaging / Q000473:pathology; D012680:Sensitivity and Specificity; D013122:Spinal Diseases / Q000000981:diagnostic imaging* / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
keywords: MRI; Modic changes; Spine; Susceptibility-weighted magnetic resonance imaging