To assess which additional spine pathologies are visualized in sagittal reformations obtained from routine multislice computed tomography (MSCT) studies of the thorax and abdomen and to investigate how frequently these pathologies were missed in the official radiology report based on the axial sections.

A routine abdominal or thoracoabdominal MSCT using a standard protocol (collimation: 16x0.75 mm, 200 mAs, 120 kVp) was performed in 112 subsequent postmenopausal women (age 67.4±8.2). From these routine datasets images were reconstructed with a collimation of 1 mm and an increment of 0.8 mm. Axial images and sagittal reformations were analyzed separately by two radiologists in consensus and were compared in order to evaluate how often spine pathology could be detected. In addition the official radiology reports were assessed to determine how many of those pathologies were identified.

Spine pathology was visualized in 101/112 postmenopausal women in the MSCT data. We found 26 patients with osteoporotic vertebral deformities, 2 of these were shown in the axial images and none of these were mentioned in the official radiology report. In addition 73 patients with degenerative disc disease, 63 with osteoarthritis of the facet joints, 28 with scoliosis, 42 with sacro-iliac joint osteoarthritis, 3 with hemangioma and 4 patients with bone metastases were identified. Most of these spine pathologies were better visualized using sagittal reformations compared to the axial MSCT data. In only 8/101 patients spine pathologies were mentioned in the official radiology report.

This study demonstrates that sagittal reformations of standard MSCT images provide important additional information on spine pathology. In particular osteoporotic vertebral deformities are substantially better detected in sagittal reformations of the axial MSCT image data. Therefore we suggest sagittal reformations of the spine as a standard in patients at risk for osteoporosis and other spine pathology.

Sagittal reformations of standard MSCT images provide important additional information on spine pathology and should be obtained in patients at risk for osteoporosis and other spine pathology.