DIAGNOSTIC ACCURACY OF DWI IN DIFFERENTIATION OF OSTEOPOROTIC COMPRESSION FRACTURE VS MALIGNANT COMPRESSION FRACTURE

ABSTRACT:
Objective: To determine the value of adding diffusion weighted images DWI to a standard MRI protocol to differentiate
acute osteoporotic and malignant compression fractures of spine at 1.5T MR Machine.
Methods: The study was conducted at the Radiology Department of Khyber teaching hospital, Peshawar from 1st
January 2014 to 31st December 2015. Fifty patients with vertebral compression fractures who were diagnosed on
X-ray were included. Diffusion weighted sequences and apparent diffusion coefficient images on a 1.5 T MR scanner
were obtained in all patients to identify the cause of the vertebral compression fracture as benign or malignant. The
observation was compared to histopathological findings.
Results: Diffusion weighted MR imaging was found to be 90% sensitive, 76% specific with positive predictive value of
97% and negative predictive value of 85% in differentiation of benign and malignant vertebral compression fractures.
Conclusion: DWI is a noninvasive accurate method to differentiate between benign and malignant compression fractures
of spine.
Key Words: Osteoporotic compression fracture spine, Malignant Compression fracture, DWI, MRI.