Acute vertebral collapse: CT findings in benign and malignant nontraumatic cases.

Abstract

CT can help distinguish benign from malignant causes of nontraumatic AVC.

Pedicle Involvement on MR Imaging Is Common in Osteoporotic Compression Fractures

“…For many years, various diagnostic signs on CT and MR imaging have been considered useful for such evaluation. [1][2][3][4][5][6][7][8][9][10][11][12] Morphologic changes suggest malignancy when a convex posterior cortex of the vertebral body is seen due to a mass effect or epidural and/or paravertebral masses. [1][2][3][4]8 Among these signs, the presence of an epidural mass has been reported as both specific and sensitive.…”

“…3 In addition, findings such as destruction of anterolateral or posterior cortical bone of the vertebral body or the pedicle on CT have been reported to suggest a malignant process. 2 On the other hand, benign osteoporotic compression fractures show various signal-intensity patterns on MR imaging.…”

“…In addition, retropulsion of a posterior bone fragment is considered both sensitive and specific for osteoporotic fractures. 2 The usefulness of diffusion-weighted MR imaging or chemical shift MR imaging in differentiating benign and malignant vertebral lesions has been reported recently, but the results are controversial. 13,14 Correct diagnosis can be made in most cases of osteoporotic compression fracture because the useful signs mentioned above usually coexist in the collapsed vertebrae.…”

“…Compression fractures due to malignant tumors have a convex posterior cortex of the vertebral bodies, epidural or paravertebral masses, or infiltration of the posterior elements. [1][2][3][4][5] Of these, pedicle involvement has been described as specific for malignant lesions. 3 Osteoporotic compression fractures usually show retropulsion of a posterior bone fragment or intravertebral fluid.…”

“…3 Osteoporotic compression fractures usually show retropulsion of a posterior bone fragment or intravertebral fluid. 2,3,5,6 In our experience of PV for painful compression fractures, abnormal signal-intensity change in the pedicle on MR imaging, which will be defined as "pedicle involvement," has commonly been noted not only in patients with malignant compression fractures but also in those with benign osteoporotic compression fractures, and differentiation by using only this sign is sometimes difficult.…”