Dynamic contrast-enhanced magnetic resonance imaging of osteoporotic vertebral fracture

This was a retrospective study of the relation between the blood perfusion of bone marrow in injured vertebrae and the degree of subsequent vertebral collapse in patients with osteoporotic vertebral fractures.

The objective was to evaluate blood perfusion of bone marrow in injured vertebrae using dynamic magnetic resonance imaging and study the possibility of predicting the progression of vertebral collapse.

Avascular necrosis of the vertebra is considered to be a cause of delayed vertebral collapse following osteoporotic vertebral fractures, but studies on the relation with the degree of progression of vertebral collapse by evaluation of vertebral blood perfusion have not been reported.

The subjects were 15 vertebrae in 14 patients with osteoporotic vertebral fractures, including 11 women and three men with a median age of 79 years. All patients underwent dynamic magnetic resonance imaging soon after the fracture and the area rate of the noncontrast region of the injured vertebrae in dynamic magnetic resonance imaging was measured. The correlation with the degree of progression of vertebral collapse obtained from plain radiograph imaging was studied.

The vertebral collapse rate (percentage loss in vertebral body height) on initial examination was 17 +/- 10% (mean +/- SD) and that at the final examination was 33 +/- 19%, showing a progression of 16 +/- 11%. The noncontrast area rate in dynamic magnetic resonance imaging was 18 +/- 12%. A significant correlation was found between the degree of progression of vertebral collapse and the noncontrast area rate (Spearman r = 0.97, P < 0.001).

The subsequent progression of vertebral collapse tended to increase the greater the noncontrast area in the injured vertebrae in dynamic magnetic resonance imaging. Dynamic magnetic resonance imaging appears to be useful in predicting the progression of collapse of fractured vertebrae.