Department Diagnostic Radiology, Singapore General Hospital, Outram Rd., Singapore 169608, Singapore.
Eur Radiol. 2013 Feb;23(2):541-50. doi: 10.1007/s00330-012-2620-1. Epub 2012 Aug 18.
To determine the residual lipid fraction in fractured vertebrae by (1)H MR spectroscopy (MRS) and its confounding effect on differentiating benign from metastatic compression fractures of the spine using apparent diffusion coefficient (ADC) obtained by diffusion-weighted read-out-segmented echo-planar imaging.
Fifty-two patients presenting with back pain and/or vertebral compression fractures related to different degrees of acute trauma, osteoporosis or clinically known metastatic disease underwent imaging at 1.5 T using (a) single-voxel MRS for water and lipid compositions over the fractured vertebral marrow, and (b) DWI at b = 0 and 650 s/mm(2) to compute the ADC values.
In 46 fractured vertebrae, the amount of lipid displaced was variable. In low-impact trauma, lipid was either displaced partially (ADC of 1.60 ± 0.20 × 10(-3) mm(2)/s) or almost totally with a higher ADC (2.20 ± 0.27 × 10(-3) mm(2)/s). In acute high-impact trauma, the lipid fraction was negligible, yet an intermediate ADC was observed. In tumour infiltration, ADC was also intermediate (1.22 ± 0.14 × 10(-3) mm(2)/s) despite a negligible lipid fraction. The ROC curve yielded a diagnostic accuracy of 0.944.
ADC-MRS analysis provides knowledge of the residual lipid fraction in fractured vertebrae that could aid in the differentiation between benign and metastatic vertebral fractures in low-impact trauma.
通过磁共振波谱（MRS）确定骨折椎骨中的残余脂质部分，并利用扩散加权读出分段回波平面成像（DWI）获得的表观扩散系数（ADC）来区分良性和转移性脊柱压缩性骨折。
52 例因急性创伤、骨质疏松症或已知转移性疾病程度不同而出现背痛和/或椎体压缩骨折的患者在 1.5T 磁共振成像上进行检查，采用（a）单体素 MRS 检测骨折骨髓中的水和脂质成分，（b）b 值为 0 和 650 s/mm² 的 DWI 计算 ADC 值。
在 46 个骨折椎骨中，移位的脂质量不同。在低冲击力创伤中，脂质部分或完全移位，ADC 值分别为 1.60±0.20×10(-3)mm²/s（1.60±0.20×10(-3)mm²/s）和 2.20±0.27×10(-3)mm²/s（2.20±0.27×10(-3)mm²/s）。在急性高冲击力创伤中，脂质部分可以忽略不计，但 ADC 值为中等水平。在肿瘤浸润中，尽管脂质部分可以忽略不计，但 ADC 值也为中等水平（1.22±0.14×10(-3)mm²/s）。ROC 曲线的诊断准确性为 0.944。
ADC-MRS 分析提供了骨折椎骨中残余脂质部分的知识，有助于区分低冲击力创伤中的良性和转移性椎体骨折。
