Acute vertebral collapse due to osteoporosis or malignancy: appearance on unenhanced and gadolinium-enhanced MR images.

Cuénod, C.A.; Laredo, Jean‐Denis; Chevret, Sylvie; Hamzé, B.; Naouri, J.-F.; Chapaux, X; Bondeville, J.-M.; Tubiana, Jean-Michel

doi:10.1148/radiology.199.2.8668809

Cited by 217 publications

(129 citation statements)

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“…MRI is now the method of choice to detect the presence and extent of spinal metastasis. MRI imaging proves helpful because multiple lesions that are not suspected clinically are found in 30% of cases [13] [14]. In our case, MRI findings revealed intramedullary T2 hyperintense signal intensity from C7 to T2 and D9 to conus.…”

Section: Discussionmentioning

confidence: 54%

Multiple Spinal Intradural-Intramedullary Involvement by Metastatic Carcinoma with Neuroendocrine Differentiation with Occult Primary—An Unusual Case Report and Review of Literature

Gupta¹,

Sinha²

2016

OJPathology

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Although vertebral column is recognized as the most common site for bony metastasis in patient with systemic malignancy, intramedullary metastases to the spinal cord is infrequent. Between 5% -10% of cancer patients develop spinal metastasis during the course of their diseases. Intramedullary tumors are rare, comprising 3.5% of spinal metastasis. Most metastatic spinal lesions (70%) are found at the thoracic level, 20% in lumbar region and 10% in the cervical region. We report a rare biopsy proven case of intramedullary spinal metastatic carcinoma with neuroendocrine differentiation because of its unusual presentation, involving spine at multiple noncontiguous levels, which appeared as irregular small nodules on MRI. The primary tumor was most likely from occult primary in lung. Biopsy from the spinal lesion established the diagnosis of metastatic carcinoma with neuroendocrine differentiation. Therefore, in patients with spinal metastasis, a thorough work up is advised to evaluate primary site. This would help to delineate the nature and the extent of the systemic disease. We highlighted herein the clinical presentation, radiological findings particularly MRI and role of biopsy in the diagnosis and treatment of intramedullary spinal metastasis.

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Section: Discussionmentioning

confidence: 54%

Multiple Spinal Intradural-Intramedullary Involvement by Metastatic Carcinoma with Neuroendocrine Differentiation with Occult Primary—An Unusual Case Report and Review of Literature

Gupta¹,

Sinha²

2016

OJPathology

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“…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.…”

Section: Discussionmentioning

confidence: 99%

“…Pedicle involvement has also been described as specific for malignant lesions. 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.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

mentioning

confidence: 99%

“…[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. 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.…”

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confidence: 99%

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Pedicle Involvement on MR Imaging Is Common in Osteoporotic Compression Fractures

Ishiyama¹,

Fuwa²,

Numaguchi³

et al. 2009

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Pedicle involvement on MR imaging has been considered specific for malignancy. However, we also noted the findings in many patients with osteoporosis and hypothesized that it is not specific for malignant lesions. The aim of this study was to evaluate the prevalence of pedicle involvement in painful osteoporotic compression fractures and to determine whether the sign is specific for malignancy.

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Quantitative analysis of vertebral bone marrow perfusion using dynamic contrast‐enhanced MRI: Initial results in osteoporotic patients with acute vertebral fracture

Biffar¹,

Schmidt

Sourbron

et al. 2011

Magnetic Resonance Imaging

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Purpose: To evaluate the potential of quantitative dynamic contrast-enhanced MRI (DCE-MRI) in vertebral bone marrow (vBM) of patients with acute osteoporotic vertebral compression fractures. Materials and Methods:Twenty-six patients with acute osteoporotic fractures (16 female, 10 male, median age 72, range 48-89) and 10 subjects without known history of osteoporosis (6 female, 4 male, median 65, range 31-77) were examined 2D-DCE-MRI. Region of interest (ROI) data in fractured (n ¼ 26) and normal-appearing vertebrae (n ¼ 271) were analyzed with a two-compartment tracer-kinetic-model, providing estimates of at least three independent parameters: plasma flow (PF), plasma volume (PV), and extraction flow (EF). Parameters were correlated with dual x-ray absorptiometry (DXA) (n ¼ 15) and quantitative computed tomography (QCT) densitometry (n ¼ 10).Results: Mean PF was significantly higher in fractures than in normal-appearing vertebrae (69.37 vs. 11.72 mL/ 100 mL/min). Similarly, mean PV and EF differed significantly. Mean PF was significantly decreased in normalappearing vBM osteoporotic patients compared to the control group. Mean PF and PV were significantly decreased in lumbar compared to thoracic vertebrae. PV showed a significant correlation with QCT.Conclusion: Perfusion parameters were decreased significantly in normal-appearing vBM of patients. Furthermore, significant perfusion alterations were observed in acute osteoporotic vertebral fractures compared to normalappearing vertebrae.

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Acute vertebral collapse due to osteoporosis or malignancy: appearance on unenhanced and gadolinium-enhanced MR images.

Abstract: Gadolinium-enhanced and unenhanced MR images are useful in the differentiation of vertebral collapses.

Cited by 217 publications

References 0 publications

Multiple Spinal Intradural-Intramedullary Involvement by Metastatic Carcinoma with Neuroendocrine Differentiation with Occult Primary—An Unusual Case Report and Review of Literature

Multiple Spinal Intradural-Intramedullary Involvement by Metastatic Carcinoma with Neuroendocrine Differentiation with Occult Primary—An Unusual Case Report and Review of Literature

Pedicle Involvement on MR Imaging Is Common in Osteoporotic Compression Fractures

Quantitative analysis of vertebral bone marrow perfusion using dynamic contrast‐enhanced MRI: Initial results in osteoporotic patients with acute vertebral fracture

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