Wonglaksanapimon Suwimon, Chawalparit Orasa, Khumpunnip Sutiporn, Tritrakarn Siri-On, Chiewvit Pipat, Charnchaowanish Panida
Department of Radiology, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2012 Jan;95(1):81-7.
To evaluate the diagnostic performance of apparent diffusion coefficient (ADC) value in discriminating benign from malignant vertebral compression fracture.
22 symptomatic patients with compression fracture of vertebra referred for conventional MRI spines during January 2009-March 2010 underwent additional diffusion weighted MR techniques. Evaluation of diffusion weighted MR imaging and quantified ADC value from reconstructed ADC map were performed. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of apparent diffusion coefficient (ADC) value were calculated.
A total of 39 vertebral fractures; 7 malignant compression fractures and 32 benign compression fractures were evaluated. The difference between ADC values of malignant, benign compression fracture and normal vertebrae were statistically significant (p < 0.0001). The accuracy, sensitivity and specificity were 89.7%, 85.7% and 90.6% respectively with the ADC threshold of 0.89 to discriminate malignancy.
The ADC promises to be an effective implement for characterization of vertebral body compression fracture in differentiating benign and malignant compression fractures.
评估表观扩散系数（ADC）值在鉴别椎体压缩性骨折良恶性方面的诊断性能。
2009年1月至2010年3月期间，22例因椎体压缩性骨折有症状而接受常规脊柱MRI检查的患者，额外接受了扩散加权磁共振技术检查。对扩散加权磁共振成像进行评估，并从重建的ADC图中量化ADC值。计算表观扩散系数（ADC）值的准确性、敏感性、特异性、阳性预测值和阴性预测值。
共评估了39处椎体骨折；其中7处为恶性压缩性骨折，32处为良性压缩性骨折。恶性、良性压缩性骨折与正常椎体的ADC值差异具有统计学意义（p < 0.0001）。以0.89为ADC阈值鉴别恶性病变时，准确性、敏感性和特异性分别为89.7%、85.7%和90.6%。
ADC有望成为鉴别椎体压缩性骨折良恶性的有效手段。
