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Related Experiment Videos

Intravertebral vacuum cleft: changes in content after supine positioning

J Malghem1, B Maldague, M A Labaisse

  • 1Department of Radiology, Louvain University, St-Luc University Hospital, Brussels, Belgium.

Radiology
|May 1, 1993
PubMed
Summary

Intravertebral vacuum clefts, indicative of avascular necrosis, show dynamic changes within an hour of supine positioning. Recognizing these imaging patterns is crucial for accurate diagnosis and avoiding misinterpretation as infection or malignancy.

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Area of Science:

  • Radiology
  • Orthopedic Imaging
  • Spine Imaging

Background:

  • Intravertebral vacuum clefts are associated with avascular necrosis of the spine.
  • These clefts can be mistaken for other pathologies like infection or malignancy.
  • Understanding their dynamic nature is important for accurate diagnosis.

Purpose of the Study:

  • To investigate the dynamic changes in intravertebral vacuum clefts.
  • To characterize the imaging appearance of these clefts over time after supine positioning.
  • To emphasize the diagnostic significance of vacuum clefts in collapsed vertebral bodies.

Main Methods:

  • Sequential radiographic and magnetic resonance (MR) imaging examinations were performed.
  • Nine patients with intravertebral vacuum clefts indicative of avascular necrosis were included.

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  • Imaging was assessed after patients were placed in a supine position.

    • Main Results:

    • Progressive changes in cleft content were observed within one hour of supine positioning.
    • Initially, a gaslike pattern (radiolucent band on radiographs, signal void on MR) was seen during spinal extension.
    • Later, the vacuum phenomenon resolved, replaced by a fluidlike high-signal-intensity pattern on T2/T2*-weighted MR images, suggesting fluid inflow.

    Conclusions:

    • Intravertebral vacuum clefts exhibit dynamic changes in response to patient positioning.
    • Recognition of these changes on imaging is vital to differentiate from malignancy or infection.
    • Prompt imaging after supine positioning aids in the identification of vacuum clefts in collapsed vertebral bodies.