[Osteoporotic stress fractures of the sacrum: MR-tomography findings].
OBJECTIVE
Evaluation of the morphologic appearance of sacral osteoporotic insufficiency fractures in MRI.


METHODS
6 patients (5 female and one male, 54-80 years) with osteoporotic insufficiency fractures of the sacrum were examined with CT and MRI. Plain and contrast-enhanced T1- and T2-weighted spin-echo images were acquired, three patients were studied with T1-weighted gradient-echo-sequences with fat suppression.


RESULTS
Fracture-lines and sclerotic areas of the massae laterales were visible in 5 of 6 CT examinations, one patient showed no abnormalities of the sacrum on the initially performed CT scans. All patients had a diffuse bone marrow oedema of the fractured massae laterales with a decreased signal on the T1-weighted spin-echo images and an increased signal on the T1-weighted gradient-echo images with fat suppression and in the T2-weighted SE-sequences. Gadopentate dimeglumine enhanced MRI images showed a remarkable diffuse configurated high signal of the whole sacrum in bilateral fractures (H-pattern). An additional soft tissue mass could be excluded in each case.


CONCLUSIONS
Gadopentate dimeglumine enhanced MRI of sacral insufficiency fractures allows early diagnosis and helps to exclude intraosseous tumour formation.
Staatz
G
G
Klinik für Radiologische Diagnostik, RWTH Aachen.
Adam
G
G
Kilbinger
M
M
Günther
R W
RW
D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D004338:Drug Combinations; D005260:Female; D015775:Fractures, Stress / Q000473:pathology*; D005682:Gadolinium; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008536:Meglumine; D008875:Middle Aged; D009942:Organometallic Compounds; D010024:Osteoporosis / Q000150:complications* / Q000473:pathology; D004369:Pentetic Acid / Q000031:analogs & derivatives; D012447:Sacrum / Q000293:injuries* / Q000473:pathology*; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D004338:Drug Combinations; D009942:Organometallic Compounds; D008536:Meglumine; D004369:Pentetic Acid; D005682:Gadolinium; D019786:Gadolinium DTPA