Solitary vertebral collapse: distinction between benign and malignant causes using MR patterns.
Differentiation of benign from malignant causes of vertebral compression fracture can be difficult at a single location. We studied 37 patients with solitary vertebral collapse (SVC) in the spine using magnetic resonance imaging (MRI). Sixteen of them were found to have a benign cause of SVC, while the remaining 21 were found to have malignancy. The following four MRI characteristics were investigated: ill- or well-defined margin of the intravertebral lesion (P < 0.005); pedicle involvement (P < 0.05); MR enhancement pattern (P < 0.005); and paravertebral soft tissue lesion (PSL) (P < 0.025). It was found that cases of malignant SVC tended to have an ill-defined margin, abnormal signal involvement of the pedicle, a marked and heterogenous MR enhancement pattern, and irregular nodular-type PSL. Pedicle change with expansile lesion totally excluded a benign cause. By using these criteria, we were able to differentiate benign or malignant causes of SVC accurately.
Shih
T T
TT
Department of Radiology, National Taiwan University, Medical College and Hospital, Taipei. ttfshih@ha.mc.ntu.edu.tw
Huang
K M
KM
Li
Y W
YW
D000368:Aged; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D005260:Female; D005598:Fractures, Spontaneous / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013122:Spinal Diseases / Q000150:complications*; D016103:Spinal Fractures / Q000175:diagnosis* / Q000209:etiology; D013125:Spinal Neoplasms / Q000150:complications / Q000556:secondary*; D013904:Thoracic Vertebrae / Q000473:pathology