Purpose: To evaluate the diagnostic performance of susceptibility-weighted magnetic resonance imaging (SWMR) for the differentiation of sclerotic and non-sclerotic Modic changes (MC) of the spine compared to computed tomography (CT) and radiographs.
Materials and methods: The Institutional Ethics-Review-Board approved this prospective study in advance. Written consent was obtained from all subjects. SWMR and standard T1/T2 MR of the cervical (n=21) and/or lumbar spine (n=34) were performed in 54 patients. 21 patients served as control. 18 patients were evaluated with CT; in all other patients radiographs were available. 67 Modic changes were identified on T1/T2 MR. On SWMR changes were classified as sclerotic and non-sclerotic based on signal intensity measurements. The sensitivity and specificity of SWMR and T1/T2 MR for differentiating between sclerotic and non-sclerotic Modic changes were determined with CT and radiographs as reference standard.
Results: On SWMR, signal measurements between sclerotic and non-sclerotic Modic changes differed significantly (p<0.01). On T1- and T2-weighted MR no significant difference (p>0.05) was measured. On SWMR, a reliable differentiation between sclerotic and non-sclerotic Modic changes could be achieved, with a sensitivity of 100% and specificity of 95%. In contrast, the combination of T1-/T2-weighted MR yielded a significantly lower sensitivity to detect sclerosis (20%).
Conclusion: SWMR allows a reliable detection of sclerosis in Modic changes with a higher accuracy compared to standard spine MR sequences, using radiographs and CT as reference standard.
Keywords: MRI; Modic changes; Spine; Susceptibility-weighted magnetic resonance imaging.
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