THE ROLE OF TC99M MDP SKELETAL SCINTIGRAPHY AND MRI IN ASSESSMENT OF OSTEOPROTIC VERTEBRAL COLLAPSE

Abstract

Accurate diagnosis of osteoporotic vertebral collapse of the symptomatic vertebra is essential prior to deciding the treatment protocols
The purpose of the present study to evaluate the efficacy of Tc 99m MDP bone scanning and MRI to diagnose symptomatic vertebra induced by new fracture, in elderly patients with osteoporotic vertebral compression fracture.
Methods Among the patients diagnosed with osteoporotic vertebral compression fracture from November 2009 to February 2012, 39 patients (77 vertebral bodies) were performed a bone scan and MRI within a 3 month interval period, and we retrospectively examined and analyzed these patients. according to the number of the vertebral bodies showing active uptake lesions in linear pattern, the cases were divided into a single vertebral body group, a 2 vertebral body group and a more than 3 vertebral body group. Results Among the 39 patients (77 vertebral bodies) who underwent a bone scan and MRI,76% of the linear active uptake lesions determined by a bone scan were confirmed to be new fracture by MRI, 100%, 69% and 33% of the cases with a hot uptake on a bone scan in 1, 2 and 3 more than vertebral bodies, respectively, were confirmed to be new fracture by MRI
Conclusion: Bone scan could play an important role as an initial diagnostic tool and help decide the appropriate treatment protocols. These also applied but to a lesser extent in two levels vertebral fracture but , but for the fracture involving more than 2 vertebral bodies, the possibility of confirming the hot uptake lesion as a new fracture by bone scanning is low, and so MRI is required to make the diagnosis.
(Key words: Tc99m MDP skeletal scintigraphy, Osteoprosis, vertebral collapse)