Usman Zafar, Adeel Asghar Malik, Irum Shahzad, Mutahira Mannan, Qurat-ul Ain Sahi, Sameera Amir.
Diagnostic Accuracy of Qualitative Diffusion Weighted MRI of Spine in Differentiating between Benign and Malignant Vertebral Fractures Taking Histopathology as Gold Standard.
Pak J Med Health Sci Jan ;14(2):390-2.

Background: Qualitative diffusion weighted magnetic resonance imaging of spine can be used to determine the nature of lesion. Current study was carried out to find the diagnostic accuracy. Aim: To determine the diagnostic accuracy of qualitative diffusion weighted magnetic resonance imaging of spine in differentiating between benign and malignant vertebral fractures. Study duration:1 st July 2016 to 30th June 2017. Methods: 280 patients with vertebral fractures on digital x ray of spine showing decreased vertebral body height, reduced disc intervertebral disc space or collapsed vertebra as reported by a radiologist were included. Magnetic resonance imaging of spine both plain and diffusion weighted Imaging was carried out. A single consultant radiologist reported the Vertebral Fracture as benign or malignant lesion without prior knowledge of biopsy results. Results: Mean age was 42.61 +- 11.79. 156 patients (55.7%) were male and rest of 124 patients (44.3%) were female. 25 patients (8.9%) showed up with malignant lesion on MRI whereas 255 patients (91.1%) had benign lesion. 32 patients (11.4%) showed up with malignant lesion on histopathology whereas 248 patients (88.6%) had benign lesion. For whole cohort, we came up with sensitivity53.12%, specificity 96.77%, positive predictive value 68%, negative predictive value 94.11% and diagnostic accuracy 91.78%. Conclusion: This study concluded that diagnostic accuracy of qualitative diffusion weighted magnetic resonance imaging of spine in differentiating malignant and benign vertebral fractures is acceptable at current sample size.

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