Vertebral compression fractures in multiple myeloma. Part I. Distribution and appearance at MR imaging.
OBJECTIVE
To study the appearance and distribution of vertebral compression fractures on magnetic resonance (MR) images in patients with multiple myeloma.


METHODS
Two hundred twenty-four vertebral compression fractures were studied on 216 sagittal T1-weighted spin-echo and T2*-weighted gradient-echo MR images of the thoracolumbar spine obtained before and during treatment in 37 patients with multiple myeloma. Vertebral compression fractures observed at diagnosis and during follow-up were determined as being benign- or malignant-appearing at MR imaging according to literature criteria, and their distribution along the spine was recorded.


RESULTS
One hundred forty-nine (67%) of the 224 vertebral compression fractures appeared benign; 75 (33%) appeared malignant. Of the 37 patients, 14 (38%) had only benign-appearing vertebral compression fractures at diagnosis. One hundred five fractures (87%) were observed between T-6 and L-4, and 112 (50%) occurred between T-11 and L-3. Eight (4%) vertebral compression fractures involved the upper three thoracic vertebrae.


CONCLUSIONS
Most vertebral compression fractures in patients with multiple myeloma appear benign at MR imaging, and their distribution is similar to that observed in osteoporotic fractures. The possibility of multiple myeloma should not be excluded in patients with benign-appearing vertebral compression fractures at MR imaging.
Lecouvet
F E
FE
Department of Medical Imaging, St Luc University Hospital, University of Louvain, Brussels, Belgium.
Vande Berg
B C
BC
Maldague
B E
BE
Michaux
L
L
Laterre
E
E
Michaux
J L
JL
Ferrant
A
A
Malghem
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D018460:Fractures, Comminuted / Q000175:diagnosis* / Q000209:etiology; D005598:Fractures, Spontaneous / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000175:diagnosis* / Q000209:etiology