Dynamic contrast-enhanced perfusion MR imaging of diseased vertebrae: analysis of three parameters and the distribution of the time-intensity curve patterns

Objective: To assess the diagnostic value of perfusion MR imaging of diseased vertebrae by analysis of three parameters and the distribution of the time-intensity curve (TIC) patterns. Design and patients: Dynamic MR imaging was performed on 34 patients with 48 lesions. All lesions were assigned to one of four groups: osteoporotic compression fracture, benign lesion without compression fracture, pathologic compression fracture, or metastatic lesion without fracture. Peak enhancement, steepest slope, and slope value were calculated from the TIC of diseased vertebrae. TICs were classified into five types. Comparisons were made among groups by analysis of the three parameters and the distributions of the TICs pattern. Result: All parameters of pathologic compression fracture were significantly higher than those of osteoporotic compression fracture (P < 0.05). The steepest slopes of metastatic lesions with and without pathologic compression fracture were significantly higher than those of benign lesions without compression fracture (P < 0.05). No characteristic distribution of the TIC pattern helpful for the differentiation of benign and metastatic lesions was found. Conclusion: In distinguishing osteoporotic from pathologic compression fractures, semiquantitative analysis of the perfusion MR imaging may be useful. However, the analysis of the TIC patterns can not significantly contribute to the differential diagnosis.