Acute vertebral compression fracture: Differentiation of malignant and benign causes by diffusion weighted magnetic resonance imaging

Objective: to evaluate the sensitivity, specificity and accuracy of diffusion weighted (dwi) magnetic resonance imaging (mri) in the diagnosis and differentiation between benign (osteoporotic/infectious) and malignant vertebral compression fractures in comparison with histology findings and clinical follow up.methods: the study was conducted at the radiology department, aga khan university hospital (akuh) karachi. it was a one year cross-sectional study from 01/01/2009 to 01/01/2010. forty patients with sixty three vertebral compression fractures were included. diffusion-weighted sequences and apparent diffusion coefficient (adc) images on a 1.5 t mr scanner were obtained in all patients to identify the vertebral compression fracture along with benign and malignant causes. imaging findings were compared with histopathologic results and clinical follow-up.results: diffusion-weighted mr imaging found to have, 92% sensitivity, 90% specificity and accuracy of 85% in differentiation of benign and malignant vertebral compression fracture while ppv and npv were 78 % and 90% respectively.conclusion: diffusion weighted magnetic resonance imaging offers a safe, accurate and non invasive modality to differentiate between the benign and malignant vertebral compression fracture.