Spinal involvement of hematopoietic malignancies and metastasis: differentiation using MR imaging

The purpose of this study was to determine the usefulness of magnetic resonance imaging (MRI) for distinguishing spinal involvement of hematopoietic malignancies (lymphoma, leukemia, and multiple myeloma) from metastasis. 62 spinal MRIs were obtained in 60 patients with hematopoietic malignancies (n = 24) and metastasis (n = 36) in clinically and pathologically proven cases. MRI findings were evaluated in each group of patients for the pattern of involvement, signal change of vertebral body, location of paraspinal mass formation, location of epidural mass formation, cortical destruction, contour change, and compression fracture. Diffuse involvements were more commonly seen in hematopoietic malignancies than in metastasis (p < 0.05). Signal change confined to anterior element was seen in 9 metastasis but was not seen in hematopoietic malignancies. Cortical destructions were more commonly seen in metastasis than in hematopoietic malignancies (p < 0.05). Other findings did not show any statistical significance in both groups. MRI findings such as diffuse involvement, posterior epidural mass formation, and cortical destruction were useful to distinguish spinal involvement of hematopoietic malignancies and metastasis.