Reporting of Osteoporotic Vertebral Fracture Detected Opportunistically on Thoraco-abdominal Computed Tomography
L Catalan, F Xiao, JF Griffith
Hong Kong J Radiol 2019;22:230-4
https://doi.org/10.12809/hkjr1916919
Introduction: The aim of the present study was to investigate the reporting of opportunistic vertebral fracture detected on sagittal spinal reconstructions during thoraco-abdominal computed tomography (CT) examinations.
Methods: CT examinations and radiological reports of 500 patients aged >50 years, with no known malignancy or recent trauma history, who underwent thoraco-abdominal CT examinations from March to June 2017 at our hospital were reviewed. The study group included 290 men and 210 women, mean age 65 ± 9 years. A standardised semi-quantitative approach was used to identify and grade vertebral fracture. All cases were
reviewed by a single experienced musculoskeletal radiologist. Patients with clear metastatic fracture (n = 31)
were excluded. CT reports of all patients with osteoporotic vertebral fracture were reviewed.
Results: Of 469 patients, 69 (15%) had one or more fractures. Of these fractures, only 29 (42%) were reported in the CT reports. The terminology used for fracture description was ambiguous in 25 (86%) of the 29 reports including terms such as ‘collapse’ (n = 20, 80%), ‘wedging’ (n = 4, 16%), and ‘loss of height’ (n = 1, 4%). In no case was the severity of the fracture accurately recorded in the radiological report.
Conclusion: Opportunistic osteoporotic vertebral fractures were mostly unreported. For fractures that were reported, descriptions were ambiguous and severities were under-reported. Radiologists are encouraged to routinely report clinically relevant osteoporotic vertebral fractures on thoraco-abdominal CT accurately and nonambiguously.
Author affiliation(s):
L Catalan: Augustana College, Rock Island, Illinois, United States
F Xiao, JF Griffith: Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
中文摘要
在檢查目的非為脊柱時胸腹電腦斷層掃描報告骨質疏鬆性椎體骨折的情況
L Catalan、F Xiao、JF Griffith
引言：本研究旨在檢視胸腹電腦斷層掃描（胸腹CT）檢查期間於矢狀脊柱重建術中有機會性發現椎體骨折的情況。
方法：回顧2017年3月至2017年6月在本院接受胸腹CT檢查的500例50歲以上，無惡性腫瘤或近期外傷史患者的CT檢查及影像學報告。研究組包括290名男性和210名女性，平均年齡65±9歲。使用標準半定量方法來識別和分級椎體骨折。由轉移性腫瘤引發的椎體骨折患者（n = 31）被排除在外。本文回顧了所有CT報告中提到有骨質疏鬆性椎體骨折的病人圖像。
結果：在469例患者中，有69例（15%）有一個或多個骨折。在這些骨折報告中，CT報告佔29例（42%），當中25個（86%）用於描述骨折的術語不明確，包括「塌陷」（n = 20，80%）、「楔形」（n = 4，16%）和「高度下降」（n = 1，4%）。放射學報告中均沒有準確記錄骨折的嚴重程度。
結論：在檢查目的非為脊柱時，骨質疏鬆性椎體骨折多數未被報告。有報告的骨折其描述多不明確，也未報告其嚴重程度。應鼓勵放射科醫生在日常報告書寫中準確地報告經胸腹電腦斷層掃描檢測到的骨質疏鬆性椎體骨折。