Avascular necrosis of the vertebral body: MR imaging

Five patients with plain radiographic evidence of a compressed vertebra containing an intravertebral vacuum cleft indicative of avascular necrosis underwent magnetic resonance (MR) imaging. In these patients, the T2-weighted images revealed a distinct appearance consisting of marked and discrete hyperintensity at the location of the intravertebral cleft. T1-weighted images were hypointense in this region. Recognition of this pattern is important in the MR imaging evaluation of compression fractures of the vertebral body so that confusion with malignancy or infection may be avoided, thereby obviating additional diagnostic studies.