Research on the consistency of four imaging methods in the diagnosis of vertebral compression fractures

ZHANG Xiang; SUN Jin-lei; FU Ya-dong; WANG Yan-lin; JIN Yu-lian; LIANG Jie; LI Bao-qing

doi:10.3969/j.issn.2095-252X.2014.11.003

Abstract：Objective To analyze the consistency of magnetic resonance ( MRI ), lateral scout images of computed tomography ( CT ), reformation images of CT and X-ray plain iflms in the diagnosis of vertebral compression fractures.Methods From January 1, 2014 to April 30, 2014, 50 patients ( 398 vertebral bodies ) underwent thoracic or lumbar spine MRI and CT examinations and 70 patients ( 480 vertebral bodies ) had spine MRI and X-ray examinations, whose clinical data were retrospectivley analyzed. The vertebral body from T4 to L5 were involved. The semi-quantitative ( SQ ) method was used to classify the fractures as grade 0 to 3 according to the degree of vertebral compression. The number of vertebral bodies at different grades were respectively counted in all the patients based on the MRI, lateral scout images of CT, reformation images of CT and X-ray plain iflms. A Kappa analysis was used to assess the consistency between MRI and lateral scout images of CT and between MRI and reformation images of CT in the diagnosis of compression fractures≥ geade 1 and≥ grade 2. And then the consistency between MRI and X-ray plain iflms were assessed in the diagnosis of compression fractures≥ geade 1 and≥ grade 2. MRI was considered as the standard in the diagnosis of fractures, and grade 0 was taken as negative resultes and≥ geade 1 as positive results. Finally, the sensibility and specificity of scout images and reformation images of CT and X-ray plane films were calculated in the diagnosis of vertebral compression fractures.Results A fair consistency existed between MRI and lateral scout images of CT in the diagnosis of fractures≥ grade 1 (k=0.583 ), and a good consistency in the diagnosis of fractures≥ grade 2 (k=0.818 ). A good consistency was noticed between MRI and reformation images of CT in the diagnosis of fractures≥ grade 1 and 2 (k=0.836 andk=0.961 ). A fair consistency was found between MRI and X-ray plain iflms in the diagnosis of fractures≥ grade 1 (k=0.651 ), and a good consistency in the diagnosis of fractures≥grade 2 (k=0.862 ). The sensibility and speciifcity of lateral scout images of CT, reformation images of CT and X-ray plain iflms were 55.2% and 97.1%, 81.6% and 98.5% and 62.5% and 96.7% respectively in the diagnosis of vertebral compression fractures.Conclusions The best consistency is detected between MRI and reformation images of CT in the diagnosis of vertebral compression fractures. When compared with that of MRI, the sensibility and speciifcity of reformation images of CT are higher. And while the sensibility of lateral scout images of CT and X-ray plan iflms is higher and their speciifcity is lower than that of MRI.