Diffusion-Weighted MR Imaging for Differentiation of Benign Fracture Edema and Tumor Infiltration of the Vertebral Body

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Abstract
OBJECTIVE. The aim of this study was to investigate diffusion-weighted MR imaging for differentiation of benign fracture edema and tumor infiltration with and without accompanying fracture.SUBJECTS AND METHODS. In 10 volunteers, diffusion-weighted spin-echo, fat-suppressed spin-echo, and stimulated-echo sequences were optimized on a clinical 1.5-T scanner. In 34 patients, MR imaging with and without diffusion-sensitizing gradients (b = 598 sec/mm2 in spin-echo and fat-suppressed spin-echo, b = 360 sec/mm2 in stimulated-echo) was performed. Thirty-five lesions were analyzed, with 18 caused by acute (≤10 days old) osteoporotic or traumatic fractures and 17 caused by untreated malignant vertebral infiltration including nine fractures. Signal attenuation in diffusion-weighted images and contrast-to-noise ratio were calculated. The diffusion-weighted images were analyzed by two radiologists.RESULTS. Images from three of 34 patients were excluded because of motion artifact. In osteoporotic and traumatic fractur...