Sensitivity and specificity of Magnetic Resonance Imaging in differentiating benign and malignant causes of vertebral compression fractures

Abstract

Vertebral compression fracture is an important problem for the elderly because they are commonly exposed to this type of fracture caused by osteoporosis. MRI is used to differentiate between benign and malignant causes of vertebral body collapse and can reduce the need for biopsy and pathological examination for diagnosis. The aim of this study is to evaluation of sensitivity and specificity of Magnetic Resonance Imaging in differentiating benign and malignant causes of vertebral compression fractures. Materials and Methods: This research was a descriptive-analytical cross-sectional study and the target population was patients suspected of Vertebral compression fracture referred to Imam Reza Hospital of Tabriz for MRI in 2021 (number of 50 patients). The sampling method was accessible or easy. After oral explanations to the patients and if they wish to participate in this study, their MRI findings were studied. After undergoing open or percutaneous biopsy in their diagnostic course, these patients were informed of the definitive diagnosis of the cause of the vertebral compression fracture. After complete data collection, the sensitivity and specificity of each of the MRI findings were analyzed to predict the benign or malignant cause of the fracture. Results: In this study, among the variables related to vertebral compression fracture, the presence of epidural and paraspinal collections (P-value=0.012), anterior involvement of the vertebral body (P-value=0.004), degenerative changes of the involved vertebra (P-value=0.001) and the fracture site of the lumbar vertebrae (P-value<0.001) in the group of patients with benign vertebral compression fracture was significantly higher than in the group of patients with malignant vertebral compression fracture; While the variables of male gender (P-value=0.006) and high age group (P-value=0.048), the presence of epidural and paraspinal mass (P-value=0.012), involvement of pedicle or posterior elements (P-value=0.002), the pattern of involvement of non-adjacent vertebra (P-value<0.001) and the curvature of the posterior wall of the vertebra (P-value=0.007) in the group of patients with malignant vertebral compression fracture was significantly higher than in the group of patients with benign vertebral compression fracture; But in other variables, including diffuse involvement of the vertebra and Schmorl node, involvement of the upper and lower end plates, destruction of the vertebral cortex and intervertebral disc involvement, number of involved vertebrae, bone marrow edema, posterior protrusion of the vertebra (retropulsion) and visibility of the horizontal fracture line in T1 and T2, there was no statistically significant difference between the two groups of patients with benign and malignant vertebral compression fracture (P-value>0.05).