Value of multiplanar reformations (MPR) in multidetector CT (MDCT) of acute vertebral fractures - Do we still have to read the transverse images?

Objective: To determine the value of multiplanar reformations (MPRs) in multidetector computed tomography (MDCT) diagnosis of acute vertebral fractures and to assess the necessity to read the whole set of transverse images. Methods: Retrospectively, 56 MDCT of 55 patients with acute vertebral fractures were included. The images were analyzed by two radiologists in a consensus procedure. First, the diagnosis was made exclusively from sagittal and coronal MPRs; secondly, the transverse images were analyzed with knowledge of the MPRs. Diagnostic accuracy is given as percentage. Image amounts were compared using the Wilcoxon test. Results: In 244 vertebral bodies, all 70 fractured vertebrae were diagnosed on reviewing MPRs only. There were no false positive cases. In 2/70 fractures, the anatomically exact diagnosis was complemented by reading the transverse images. Forty-two of 43 unstable fractures were diagnosed correctly on MPRs only. With preference of MPR reading, the total number of images to be analyzed could be reduced significantly (P < 0.01). Conclusion: Reading of MPRs alone is a feasible approach for correct assessment of vertebral fractures and classifying them into stable/unstable, if MPRs are done properly. Transverse images must be analyzed in complex fractures or uncertain findings.