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Acute vertebral collapse due to osteoporosis or malignancy: appearance on unenhanced and gadolinium-enhanced MR
C A Cuénod1, J D Laredo, S Chevret
1Department of Radiology, Hôpital Saint-Antoine, Paris, France.
Purpose:
To distinguish malignant from osteoporotic acute vertebral collapses.
Materials And Methods:
Sixty-three osteoporotic and 30 malignant vertebral collapses were studied in 51 patients (aged 33-88 years) with T1-weighted magnetic resonance (MR) images (n=93), gadolinium-enhanced T1-weighted images (n=72), and T2-weighted images (n=53).
Results:
Four findings were suggestive of osteoporosis: retropulsion of a bone fragment (10 osteoporotic cases vs 0 malignant cases), preservation of normal signal intensity on T1-weighted images (43 vs four), return to normal signal intensity after gadolinium injection (42 vs four) with horizontal bandlike patterns, and isointense vertebrae on T2-weighted images (28 vs two). Six findings were suggestive of malignancy: convex posterior cortex (21 malignant cases vs four osteoporotic cases), epidural mass (24 vs 0), diffuse low signal intensity within the vertebral body on T1-weighted images (23 vs 12) and in the pedicles (24 vs four), high or inhomogeneous signal intensity after gadolinium injection (17 vs 0) and on T2-weighted images (17 vs 0).
Conclusion:
Gadolinium-enhanced and unenhanced MR images are useful in the differentiation of vertebral collapses.