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DOI: 10.1055/s-0040-1709558
MR-derived CT-like Images for the Assessment of Acute Vertebral Fractures and Osseous Degenerative Changes in the Thoracolumbar Spine
Publication History
Publication Date:
25 March 2020 (online)
Introduction Patients with spine pathologies commonly undergo both computed tomography (CT) and magnetic resonance (MR) imaging. Our purpose was to evaluate whether MR-derived CT-like images can potentially substitute for conventional CT to assess acute vertebral fractures and osseous degenerative changes.
Material and Methods Acute vertebral fractures (n = 44) as well as degenerative changes in nonfractured levels (n = 52) were evaluated in 26 patients (64 ± 16 years; 17 women) on CT and 3-T MR imaging including a high-resolution three-dimensional T1-weighted gradient-echo sequence based on which intensity-inverted CT-like images were calculated. Two radiologists evaluated morphological findings separately on CT and MR-derived CT-like images. Agreement between the two modalities as well as inter- and intrareader reproducibility were assessed using weighted Cohen’s κ and intraclass correlation coefficients (ICCs).
Results Quantitative measurements showed an almost perfect to perfect agreement among both modalities, with ICCs between 0.91 (95% confidence interval [CI], 0.74–0.96) for intervertebral foramen anteroposterior diameter and 0.99 (95% CI, 0.98–1) for vertebral body and disk height. Ordinal scaled parameters such as Genant and AO fracture classifications (each, κ 1.0) and the extent of osteophytes (κ 1.0), diffuse sclerosis (κ 0.79), and facet joint degeneration (κ 0.96) showed a substantial to perfect agreement. Inter- and intrareader ICCs as well as κ were substantial to excellent (> 0.90), respectively. Average acquisition time for the sequence was 5.12 ± 0.17 minutes.
Conclusion Excellent agreement among the two modalities and a high inter- and intrareader reproducibility suggest that for the assessment of vertebral fractures and osseous degenerative changes, MR-derived CT-like images are on par with conventional CT. This finding could spare patients additional examinations and radiation doses.
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No conflict of interest has been declared by the author(s).