Percutaneous Vertebroplasty: Relationship between Vertebral Body Bone Marrow Edema Pattern on MR Images and Initial Clinical Response

Tanigawa, Noboru; Komemushi, Atsushi; Kariya, Shuji; Kojima, Hiroyuki; Shomura, Yuzo; Ikeda, Koshi; Omura, Naoto; Murakami, Takamichi; Sawada, Satoshi

doi:10.1148/radiol.2391050073

Cited by 75 publications

(36 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Imaging procedures such as magnetic resonance (MR) imaging, bone scintigraphy, and computed tomography (CT) help determine the treatment location (5). Of these procedures, MR imaging is most favored because of its ability to provide information on both anatomic vertebral collapse and edema (1,6,7).…”

Section: Patientsmentioning

confidence: 99%

Bone Marrow Edema in Vertebral Compression Fractures: Detection with Dual-Energy CT

Wang

Tsai

Chuang³

et al. 2013

Radiology

157

View full text Add to dashboard Cite

Purpose:To assess the use of the dual-energy computed tomographic (CT) virtual noncalcium technique in the evaluation of bone marrow edema in vertebral compression fractures. Materials and Methods:This prospective study was approved by the institutional review board; informed consent was obtained from all patients. Sixty-three consecutive patients with 112 thoracic and/or lumbar vertebral compression fractures were studied between January 2011 and April 2012. All patients underwent both dual-energy CT (100 kV and Sn140 kV, where Sn indicates the use of a 0.4-mm tin filter) and magnetic resonance (MR) imaging. Dual-energy CT data were postprocessed by using a three-material decomposition algorithm for generating noncalcium images of the collapsed bodies. Two radiologists evaluated for the presence of abnormal attenuation alterations in the bone marrow by using color-coded maps and measured CT numbers on noncalcium grayscale images. Bone sclerosis and intravertebral air were evaluated with CT scans. MR images served as the reference standard. CT numbers were subjected to receiver operating characteristic curve analysis. Results:MR imaging depicted 46 edematous and 66 nonedematous vertebral compression fractures. Eighty-two bodies were classified as having less than 50% sclerosis and/or air. Significant differences in noncalcium CT numbers between edematous and nonedematous vertebral compression fractures were found for both readers (P , .0001).CT numbers for the diagnosis of bone marrow edema on the basis of MR imaging revealed areas under the receiver operating characteristic curve of 0.799 and 0.841 for readers 1 and 2, respectively (P = .56). Use of a cutoff value of 280 to differentiate edematous vertebral bodies resulted in a sensitivity of 96.3%, specificity of 98.2%, and accuracy of 97.6% in the group of vertebral bodies with less than 50% sclerosis and/or air. Conclusion:Dual-energy CT virtual noncalcium images were able to depict bone marrow in the collapsed vertebral bodies, especially in those with less than 50% sclerosis and/or air.q RSNA, 2013

show abstract

Section: Patientsmentioning

confidence: 99%

Bone Marrow Edema in Vertebral Compression Fractures: Detection with Dual-Energy CT

Wang

Tsai

Chuang³

et al. 2013

Radiology

157

View full text Add to dashboard Cite

show abstract

“…In all these cases, consensus was obtained without difficulties by authors 1 and 5. A total of 60 papers were excluded after review; 27 as they dealt with specific LBP conditions ( Table 2) and 33 for other reasons: one review article [55], four case reports [7,27,129,148], one double publication [90], one of two studies reporting data from the same study sample [80], ten for evaluating signal changes other than those related to the endplate [6,20,51,53,71,113,116,139,146,150], and eight articles because they did not report the exact numbers needed to calculate the prevalence rates of VESC [4,10,109,110,114,122,133,141]. Finally, eight articles were excluded because the study samples were selected on the basis of the presence of VESC [41, 50,56,63,68,134,137,149].…”

Section: Review Processmentioning

confidence: 99%

“…There was no difference in the prevalence rates of VESC in relation to sex in the 45 study samples that reported the Schmorl's nodes [60,94,135] Fracture [139,151] Spinal cord infarction [157] Other conditions [42, 121] prevalence in individuals or in the 22 study samples that reported the prevalence in relation to levels (data not shown).…”

Section: Sexmentioning

confidence: 99%

Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain

Jensen

Karppinen

Sorensen³

et al. 2008

Eur Spine J

400

297

View full text Add to dashboard Cite

The prevalence of ''vertebral endplate signal changes'' (VESC) and its association with low back pain (LBP) varies greatly between studies. This wide range in reported prevalence rates and associations with LBP could be explained by differences in the definitions of VESC, LBP, or study sample. The objectives of this systematic critical review were to investigate the current literature in relation to the prevalence of VESC (including Modic changes) and the association with non-specific low back pain (LBP). The MEDLINE, EMBASE, and SveMED databases were searched for the period 1984 to November 2007. Included were the articles that reported the prevalence of VESC in non-LBP, general, working, and clinical populations. Included were also articles that investigated the association between VESC and LBP. Articles on specific LBP conditions were excluded. A checklist including items related to the research questions and overall quality of the articles was used for data collection and quality assessment. The reported prevalence rates were studied in relation to mean age, gender, study sample, year of publication, country of study, and quality score. To estimate the association between VESC and LBP, 2 9 2 tables were created to calculate the exact odds ratio (OR) with 95% confidence intervals. Eighty-two study samples from 77 original articles were identified and included in the analysis. The median of the reported prevalence rates for any type of VESC was 43% in patients with non-specific LBP and/or sciatica and 6% in non-clinical populations. The prevalence was positively associated with age and was negatively associated with the overall quality of the studies. A positive association between VESC and non-specific LBP was found in seven of ten studies from the general, working, and clinical populations with ORs from 2.0 to 19.9. This systematic review shows that VESC is a common MRI-finding in patients with non-specific LBP and is associated with pain. However, it should be noted that VESC may be present in individuals without LBP.

show abstract

“…3,4 Among these procedures, MRI is the modality of choice to obtain information about both vertebral fractures and bone marrow oedema. [5][6][7][8] However, MRI is not routinely used in all patients with vertebral trauma owing to reduced availability, contraindications and/or metal artefacts. Compared with MRI, CT is more available, requires less time and has better spatial resolution.…”

Section: Introductionmentioning

confidence: 99%

The feasibility of dual-energy CT in differentiation of vertebral compression fractures

Karaca

Yuceler

Kantarcı

et al. 2016

BJR

View full text Add to dashboard Cite

Objective: To prospectively evaluate the ability of dual-energy CT (DECT), compared with MRI, to identify vertebral compression fractures in acute trauma patients. Methods: This institutional review board-approved study included 23 consecutive patients with 32 vertebral fractures who underwent both DECT and MRI of the spine between February 2014 and September 2014. A total of 209 vertebrae were evaluated for the presence of abnormal bone marrow attenuation on DECT and signal on MRI by five experienced radiologists. The specificity, sensitivity, predictive values and intraobserver and interobserver agreements were calculated. Results: MRI revealed a total of 47 vertebrae (22.4% of all vertebrae) and DECT revealed 44 vertebrae (21.0% of all vertebrae) with oedema. Using MRI as the reference standard, DECT had sensitivity, specificity, positive-predictive value, negative-predictive value and accuracy of 89.3, 98.7, 95.4, 96.9 and 96.6%, respectively. With respect to establishing the presence of oedema, the interobserver agreement was almost perfect (k 5 0.82), and the intraobserver agreement was substantial (k 5 0.80). Conclusion: Compared with MRI, DECT can provide an accurate demonstration of acute vertebral fractures and can be used as an alternative imaging modality for the assessment of vertebral fractures in patients with contraindications for MRI. Advances in knowledge: Distinguishing of acute and chronic vertebral compression fracture is important for treatment choices. DECT is very fast compared with MRI and is an alternative imaging modality for the assessment of vertebral fractures in patients with contraindications for MRI.

show abstract

Percutaneous Vertebroplasty: Relationship between Vertebral Body Bone Marrow Edema Pattern on MR Images and Initial Clinical Response

Abstract: PVP resulted in significantly greater clinical improvement in patients with an extensive bone marrow edema pattern than in those without this pattern. (c) RSNA, 2006.

Cited by 75 publications

References 7 publications

Bone Marrow Edema in Vertebral Compression Fractures: Detection with Dual-Energy CT

Bone Marrow Edema in Vertebral Compression Fractures: Detection with Dual-Energy CT

Vertebral endplate signal changes (Modic change): a systematic literature review of prevalence and association with non-specific low back pain

The feasibility of dual-energy CT in differentiation of vertebral compression fractures

Contact Info

Product

Resources

About