The Value of X-ray Compared with Magnetic Resonance Imaging in the Diagnosis of Traumatic Vertebral Fractures

Lee, Yang Woo; Jang, Jae Ho; Kim, Jin Joo; Lim, Yong Su; Hyun, Sung Youl; Yang, Hyuk Jun

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자료유형: 학술저널

저자정보: Lee, Yang Woo (Department of Emergency Medicine, Gachon University Gil Medical Center) Jang, Jae Ho (Department of Emergency Medicine, Gachon University Gil Medical Center) Kim, Jin Joo (Department of Emergency Medicine, Gachon University Gil Medical Center) Lim, Yong Su (Department of Emergency Medicine, Gachon University Gil Medical Center) Hyun, Sung Youl (Department of Trauma, Gachon University Gil Medical Center) Yang, Hyuk Jun (Department of Emergency Medicine, Gachon University Gil Medical Center)

저널정보: 대한외상학회 Journal of trauma and injury : JTI Journal of trauma and injury : JTI 제30권 제4호

발행연도: 2017.1

수록면: 158 - 165 (8page)

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Purpose: The purpose of this study was to evaluate the diagnostic accuracy of X-rays in patients with acute traumatic vertebral fractures visiting the emergency department and to analyze the diagnostic value of X-rays for each spine level. Methods: We retrospectively analyzed basal characteristics by reviewing medical records of 363 patients with adult traumatic vertebral fractures, admitted to the emergency center from March 1, 2014 to February 28, 2017. We analyzed spine X-rays and magnetic resonance imaging (MRI) scans to determine distribution according to the vertebral level, and we evaluated the efficacy of X-rays by comparing discrepancies between X-rays and MRI scans. Results: For a total of 363 patients, the mean age was 56.65 (20-93) and 214 (59%) were males. On the basis of X-rays, 67 cases (15.1%) were of the cervical spine, 133 cases (30.0%) were of the thoracic spine, and 243 cases (54.9%) were of the lumbar spine. In particular, the thoracolumbar region (T11-L2) was the most common, with 260 cases (58.7%). In X-rays, fractures were the least in the upper thoracic region (T1-T3), whereas MRI scans revealed fairly uniform distribution across the thoracic spine. Sensitivity of X-rays was lowest in the upper thoracic spine and specificity was almost always greater than 98%, except for 94.7% in L1. Positive predictive value was lower in the mid-thoracic region (T4-T9) and negative predictive value was slightly lower in C6, T2, and T3 than at other sites. Diagnostic accuracy of X-rays by vertebral body, transverse process, and spinous process according to fractured vertebral structures was significantly different according to vertebral level. Conclusions: Diagnostic accuracy of X-rays was lower in the upper thoracic region than in other parts. Further studies are needed to identify better methods for diagnosis considering cost and neurological prognosis.

#Spinal fractures #Trauma #X-rays #Magnetic resonance imaging

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