Blood perfusion of vertebral lesions evaluated with gadolinium-enhanced dynamic MRI: in comparison with compression fracture and metastasis.
OBJECTIVE
To investigate blood perfusion of vertebral lesions using dynamic Gd-DTPA-enhanced MRI.


METHODS
Dynamic MR studies were performed for cases of acute compression fracture, chronic compression fracture, metastatic vertebral lesions with or without compression fracture. A total of 42 patients (71 vertebral segments) were included. Five types of time-intensity curves (TICs) were defined as: nearly no enhancement (type A), slow enhancement (type B), a rapid contrast wash-in followed by an equilibrium phase (type C), a rapid contrast wash-in followed by early wash-out (type D), and a rapid contrast wash-in with a second slower-rising slope (type E).


RESULTS
Metastatic vertebral lesions with or without fracture had a higher peak enhancement percentage and steeper enhancement slope than those of chronic compression fracture, but had no difference as compared to those of acute compression fracture. The type D curve had high positive predictive value for metastatic group (100%), and the type E curve had high positive predictive value for benign compression fracture (85.7%).


CONCLUSIONS
Type D and E curves are valuable in the differentiation of benign and malignant vertebral lesions.
Chen
Wei-Tsung
WT
Department of Radiology, Taipei Municipal Jen-Ai Hospital, Taipei, Taiwan.
Shih
Tiffany Ting-Fang
TT
Chen
Ran-Chou
RC
Lo
Hsin-Yen
HY
Chou
Chen-Te
CT
Lee
Jiunn-Ming
JM
Tu
Hsing-Yang
HY
D000328:Adult; D000368:Aged; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D005598:Fractures, Spontaneous / Q000209:etiology / Q000473:pathology; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D016103:Spinal Fractures / Q000209:etiology / Q000473:pathology*; D013125:Spinal Neoplasms / Q000098:blood supply* / Q000473:pathology* / Q000556:secondary; D013131:Spine / Q000473:pathology*
D003287:Contrast Media; D019786:Gadolinium DTPA