Acute vertebral collapse due to osteoporosis or malignancy: appearance on unenhanced and gadolinium-enhanced MR images.
OBJECTIVE
To distinguish malignant from osteoporotic acute vertebral collapses.


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).


CONCLUSIONS
Gadolinium-enhanced and unenhanced MR images are useful in the differentiation of vertebral collapses.
Cuénod
C A
CA
Department of Radiology, Hôpital Saint-Antoine, Paris, France.
Laredo
J D
JD
Chevret
S
S
Hamze
B
B
Naouri
J F
JF
Chapaux
X
X
Bondeville
J M
JM
Tubiana
J M
JM
D000208:Acute Disease; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D005598:Fractures, Spontaneous / Q000175:diagnosis* / Q000209:etiology*; D006571:Heterocyclic Compounds; D006801:Humans; D016015:Logistic Models; D008159:Lumbar Vertebrae / Q000293:injuries*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D010024:Osteoporosis / Q000150:complications* / Q000175:diagnosis; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016103:Spinal Fractures / Q000175:diagnosis* / Q000209:etiology*; D013125:Spinal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000556:secondary; D013904:Thoracic Vertebrae / Q000293:injuries*
D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C050823:gadolinium 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetate