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Diagnostic accuracy of 3-T magnetic resonance imaging with 3D T1 VIBE versus computer tomography in pars stress fracture of the lumbar spine

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Abstract

Objective

To compare the diagnostic accuracy of 3-T magnetic resonance imaging (MRI) with thin-slice 3D T1 VIBE sequence to 128-slice computer tomography (CT) in pars stress fractures of the lumbar spine.

Materials and methods

3-T MRI and CT of 24 patients involving 70 pars interarticularis were retrospectively reviewed by four blinded radiologists. The fracture morphology (complete, incomplete, or normal) was assessed on MRI and CT at different time points. Pars interarticularis bone marrow edema (present or absent) was also evaluated on MRI.

Results

In total, 14 complete fractures, 31 incomplete fractures and 25 normal pars were detected by CT. Bone marrow edema was seen in seven of the complete and 25 of the incomplete fractures. The overall sensitivity, specificity and accuracy of MRI in detecting fractures (complete and incomplete) were 97.7, 92.3, and 95.7 %, respectively. MRI was 100 % accurate in detecting complete fractures. For incomplete fractures, the sensitivity, specificity, and accuracy of MRI were 96.7, 92.0, and 94.6 %, respectively.

Conclusions

3-T MRI with thin-slice 3D T1 VIBE is 100 % accurate in diagnosing complete pars fractures and has excellent diagnostic ability in the detection and characterization of incomplete pars stress fractures compared to CT. MRI has the added advantages of detecting bone marrow edema and does not employ ionizing radiation.

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References

  1. Jackson D, Wiltse L, Cirincione R. Spondylolysis in the female gymnast. Clin Orthop. 1976;117:658–73.

    Google Scholar 

  2. Soler T, Calderon C. The prevalence of spondylolysis in the Spanish elite athlete. Am J Sports Med. 2000;28:57–62.

    CAS  PubMed  Google Scholar 

  3. Kim H, Green D. Spondylolysis in the adolescent athlete. Curr Opin Pediatr. 2011;23:68–72.

    Article  PubMed  Google Scholar 

  4. Kruse D, Lemmen B. Spine Injuries in the sport of gymnastics. Curr Sports Med Rep. 2009;8:20–8.

    Article  PubMed  Google Scholar 

  5. Elliot S, Hutson M, Wastie M. Bone scintigraphy in the assessment of spondylolysis in patients attending a sports injury clinic. Clin Radiol. 1988;39:269–72.

    Article  Google Scholar 

  6. Lowe J, Schachner E, Hirschberg E, et al. Significance of bone scintigraphy in symptomatic spondylolysis. Spine. 1984;9:653–5.

    Article  CAS  PubMed  Google Scholar 

  7. Bellah R, Summerville D, Treves S, et al. Low back pain in adolescent athletes: detection of stress injury to the pars interarticularis with SPECT. Radiology. 1991;180:509–12.

    Article  CAS  PubMed  Google Scholar 

  8. Campbell R, Grainger A, Hide I, et al. Juvenile spondylolysis: a comparative analysis of CT, SPECT and MRI. Skeletal Radiol. 2005;34:63–73.

    Article  CAS  PubMed  Google Scholar 

  9. Hollenberg G, Beattie P, Meyers S, et al. Stress reactions of the lumbar pars interarticularis: the development of a new MRI classification system. Spine. 2002;27:181–6.

    Article  PubMed  Google Scholar 

  10. Ganiyusufoglu A, Onat L, Karatoprak O, et al. Diagnostic accuracy of magnetic resonance imaging versus computed tomography in stress fractures of the lumbar spine. Clin Radiol. 2010;65:902–7.

    Article  CAS  PubMed  Google Scholar 

  11. Leone A, Cianfoni A, Cerase A, et al. Lumbar spondylolysis: a review. Skelet Radiol. 2011;40:683–700.

    Article  Google Scholar 

  12. Kobayashi A, Kobayashi T, Kato K, et al. Diagnosis of radiographically occult lumbar spondylolysis in young athletes by magnetic resonance imaging. Am J Sports Med. 2013;41:169–76.

    Article  PubMed  Google Scholar 

  13. Zheng Z, Shan H, Li X. Fat-Suppressed 3D T1-weighted gradient-echo imaging of the cartilage with a volumetric interpolated breath-hold examination. AJR. 2010;194:W414–9.

    Article  PubMed  Google Scholar 

  14. Thomson V, Pialat J, Gay F, et al. Whole-body MRI for metastases screening: a preliminary study using 3D VIBE sequences with automatic subtraction between non contrast and contrast enhanced images. Am J Clin Oncol. 2008;31:285–92.

    Article  PubMed  Google Scholar 

  15. Blanda J, Bethem D, Moats W, et al. Defects of pars interarticularis in athletes: a protocol for nonoperative treatment. J Spinal Disord. 1993;6:406–11.

    Article  CAS  PubMed  Google Scholar 

  16. Steiner M, Micheli L. Treatment of symptomatic spondylolysis and spondylolisthesis with the modified Boston brace. Spine. 1985;10:937–43.

    Article  CAS  PubMed  Google Scholar 

  17. Morita T, Ikata T, Katoh S, Miyake R. Lumbar spondylolysis in children and adolescents. J Bone Joint Surg (Br). 1995;77:620–5.

    CAS  Google Scholar 

  18. McCleary M, Congeni J. Current concepts in the diagnosis and treatment of spondylolysis in young athletes. Curr Sports Med Rep. 2007;6:62–6.

    PubMed  Google Scholar 

  19. Dunn A, Campbell R, Mayor P, et al. Radiological findings and healing patterns of incomplete stress fractures of the pars interarticularis. Skelet Radiol. 2008;37:443–50.

    Article  Google Scholar 

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Authors and Affiliations

  1. Victoria House Medical Imaging, 316 Malvern Road, Prahran, Victoria, Australia

    E. C. Ang, A. F. Robertson, F. A. Malara, T. O’Shea, J. K. Roebert & A. H. Rotstein

  2. Monash Biomedicine Discovery Institute, Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia

    M. E. Schneider

Authors
  1. E. C. Ang
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  2. A. F. Robertson
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  3. F. A. Malara
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  4. T. O’Shea
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  5. J. K. Roebert
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  6. M. E. Schneider
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  7. A. H. Rotstein
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Correspondence to A. H. Rotstein.

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Ang, E.C., Robertson, A.F., Malara, F.A. et al. Diagnostic accuracy of 3-T magnetic resonance imaging with 3D T1 VIBE versus computer tomography in pars stress fracture of the lumbar spine. Skeletal Radiol 45, 1533–1540 (2016). https://doi.org/10.1007/s00256-016-2475-7

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  • DOI: https://doi.org/10.1007/s00256-016-2475-7

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