Assessment and comparison of the diagnostic value of CT-scan and MRI in acute traumatic spinal compression fractures

Abstract

Purpose

Vertebral compression fractures (VCFs) frequently occur in trauma patients, with a significant portion affecting younger individuals. Choosing suitable modalities is crucial in these patients to early diagnose of VCF, especially for the prevention of further consequences in VCF patients who are asymptomatic or have mild symptoms. The purpose of this study is to assess and compare the diagnostic value of CT scanning and MRI in detecting spinal compression fractures in acute traumatic patients.

Methods

This descriptive analytical study has been performed on traumatic patients with VCFs in hospital based on the magnetic resonance imaging (MRI) evidences obtained from April 2020 to February 2021. Computerized tomography (CT), MRI and demographic data of cases were collected from electronic hospital records. Two radiologists reviewed CT-scan and MRI data again.

Results

The results were organized in software SPSS 23 for statistical analysis. Compared to MRI, the sensitivity of CT-scan in the diagnosis of stable VCFs was less than 50 % at all levels; accordingly, the results were 20, 42, and 33 % at cervical, thoracic, and lumbar levels, respectively. This significant difference suggested the necessity of MRI evaluations in such cases. Additionally, the difference in sensitivity of unstable cases was significant; the obtained results were 67, 29, and 52 % at cervical, thoracic, and lumbar levels, respectively). CT-scan illustrated 100 % sensitivity for diagnosing the cases with more than 50 % vertebral body height loss (VBHL). Besides, CT-scan sensitivity in the cases with less than 50 % VBHL was 57 %, 38 %, and 47 % at cervical, thoracic, and lumbar levels, respectively.

Conclusion

CT-scan for detecting traumatic VCFs and assessing VBHL had significantly lower sensitivity than MRI, especially in the stable cases. Also, potential hazards of harmful radiation could be avoided by applying MRI instead of CT-scan.