Methodological aspects of magnetic resonance tomographic diagnostics of metastatic compressive fractures of the spine

Authors

  • Александр Павлович Мягков Zaporozhye Medical Academy of Postgraduate Educations bul. Winter, 20,69096, Zaporizhzhya, Ukraine
  • Станислав Александрович Мягков State Institute «Zaporozhye Medical Academy of Postgraduate Education of Ministry of Health of Ukraine» 20 Vintera blvd., Zaporozhye, Ukraine, 69096, Ukraine
  • Александр Сергеевич Семенцов State Institute «Zaporozhye Medical Academy of Postgraduate Education of Ministry of Health of Ukraine» 20 Vintera blvd., Zaporozhye, Ukraine, 69096, Ukraine
  • Сергей Юрьевич Наконечный State Institute «Zaporozhye Medical Academy of Postgraduate Education of Ministry of Health of Ukraine». 20 Vintera blvd., Zaporozhye, Ukraine, 69096, Ukraine

DOI:

https://doi.org/10.15587/2313-8416.2015.45164

Keywords:

МРТ, metastatic compressive fracture, pulse patterns, signal characteristics

Abstract

Aim of the study – to define an information value of the different pulse patterns for a qualitative estimation of MR-signals in the body of compressed vertebras.

Methods: 50 patients with metastatic compressive fractures (MCF) were examined using MRT. 30 (60%) mans and 20 (40%) woman, average age 60,8 +/- 12,5 years. Fractures in the different parts of spine were considered: cervical – 6 (12,0); thoracic – 25 (50,0 %); lumbar – 19 (38 %). Metastasis in the spine are more frequent at a cancer of mammary gland (20,0 %), kidneys (17,5 %) and prostate gland (15,0 %), less frequent at a cancer of lungs, thyroid gland and sarcomas (7,5 %).

MRT was done for all patients using apparatus with magnetic force 0,2, 1,5 and 0,36Т (AIRIS Mate, ECHELON of "HitachimedicalCorp.", Japan, “I-Open 0, 36” Chine)in 3 projections receiving Т1-, Т2- weighted (Т1WI, Т2WI) and diffusion-weighted images (DWI)and also images with suppression of signals from an adipose tissue (STIR, Fat/sat).

Results: the more obvious pulse patterns (PP) at MCF of spine are – STIR (97,8 %), Т1WI и DWI (80 %). DWI can be used as a screening and addition for above-listed PP. The more objective criterion for a judgment about MCF is abnormal uptake of CM (60 %) on diffuse type.

Conclusions: for MRT visualization of MCF the most optimal are the next PP – STIR, Т1WI and DWI, with a sensitivity, respectively – 97,8 %, 80 %, and 80 %. DWI must supplement but not substitute all existing PP. On the post-contrast T1WI an objective criterion for MRT diagnostics of MCF is an abnormal uptake of CM on diffuse type. An alteration of signal characteristics in the body of compressed vertebras is an evidence of an alteration of structure, but for more precise definition of its character it is necessary to study its morphological alterations

Author Biographies

Александр Павлович Мягков, Zaporozhye Medical Academy of Postgraduate Educations bul. Winter, 20,69096, Zaporizhzhya

Professor

Department of radiology

Станислав Александрович Мягков, State Institute «Zaporozhye Medical Academy of Postgraduate Education of Ministry of Health of Ukraine» 20 Vintera blvd., Zaporozhye, Ukraine, 69096

Assistant

Department of Radiology

Александр Сергеевич Семенцов, State Institute «Zaporozhye Medical Academy of Postgraduate Education of Ministry of Health of Ukraine» 20 Vintera blvd., Zaporozhye, Ukraine, 69096

Associate Professor

Department of Radiology

Сергей Юрьевич Наконечный, State Institute «Zaporozhye Medical Academy of Postgraduate Education of Ministry of Health of Ukraine». 20 Vintera blvd., Zaporozhye, Ukraine, 69096

Associate Professor

Department of Radiology

References

Sedakov, I. E. (2013). Ukrainskayaonkologiya v 2012 godu: reformy, dostizheniya, innovacii. Zdorov'e Ukrainy, 3, 6–7.

Kassar-Pullichino, V. N., Imhof, H. (2009). Spinal'nayatravma v svetediagnosticheskihizobrazhenij [Spinal injury in the light of diagnostic imaging]. Moscow: MEDpress-inform, 264.

Shah, L. M., Salzman, K. L. (2011). Imaging of Spinal Metastatic Disease. International Journal of Surgical Oncology, 2011, 1–12. doi: 10.1155/2011/769753

Nered, A. S., Kochergina, N. V., Bludov, A. B. (2013) Osobennostipatologicheskihperelomovpozvonkov. REJR, 3/2, 20–25.

Geith, T., Schmidt, G., Biffar, A., Dietrich, O., Dürr, H. R., Reiser, M., Baur-Melnyk, A. (2012). Comparison of Qualitative and Quantitative Evaluation of Diffusion-Weighted MRI and Chemical-Shift Imaging in the Differentiation of Benign and Malignant Vertebral Body Fractures. American Journal of Roentgenology, 199 (5), 1083–1092. doi: 10.2214/ajr.11.8010

Hamimi, A., Kassab, F., Kazkaz, G. (2015). Osteoporotic or malignant vertebral fracture? This is the question. What can we do about it? The Egyptian Journal of Radiology and Nuclear Medicine, 46 (1), 97–103. doi: 10.1016/j.ejrnm.2014.11.010

Shah, L. M., Hanrahan, C. J. (2011). MRI of Spinal Bone Marrow: Part 1, Techniques and Normal Age-Related Appearances. American Journal of Roentgenology, 197 (6), 1298–1308. doi: 10.2214/ajr.11.7005

Tanenbaum, L. N. (2013). Clinical Applications of Diffusion Imaging in the Spine Diffusion imaging in the spine. Proc. Intl. Soc. Mag. Reson. Med, 21, 1–21.

Pongpomsup, S., Wajanawichakorn, P., Danchaivijitr, N. (2009). Benign versus valignant compression fracture:a diagnostic accuracy of magnetic resonance imaging. J Med Assoc Thai92, 1, 64–72.

Baur, A., Stäbler, A., Arbogast, S., Duerr, H. R., Bartl, R., Reiser, M. (2002). Acute Osteoporotic and Neoplastic Vertebral Compression Fractures: Fluid Sign at MR Imaging1. Radiology, 225 (3), 730–735. doi: 10.1148/radiol.2253011413

Karchevsky, M., Babb, J. S., Schweitzer, M. E. (2008). Can diffusion-weighted imaging be used to differentiate benign from pathologic fractures? A meta-analysis. Skeletal Radiol, 37(9), 791–795. doi: 10.1007/s00256-008-0503-y

Herneth, A. M., Guccione, S., Bednarski, M. (2003). Apparent Diffusion Coefficient: a quantitative parameter for in vivo tumor characterization. European Journal of Radiology, 45 (3), 208–213. doi: 10.1016/s0720-048x(02)00310-8

Resnick, D. (Ed.) (2006). Skeletal Metastases. Bone and Joint Imaging. Philadelphia, Pa: WB Saunders Co, 1076–1092.

Published

2015-06-29

Issue

Section

Medical