Subacute osteoporotic compression fracture: Misleading magnetic resonance appearance

Abstract

Three patients with benign subacute osteoporotic vertebral compression fractures are presented. T1 weighted magnetic resonance (MR) images (SE 500/30) showed decreased vertebral signal. Because the results of the MR examination were thought to indicate malignant disease, extensive medical workups, including one biopsy, were pursued in all three patients. Routine (SE 500/30) spin-echo pulse sequences cannot definitively distinguish between benign and malignant vertebral compression fractures.

The value of apparent diffusion coefficient measurements in the differential diagnosis of vertebral bone marrow lesions

“…Infections can sometimes be difficult to diagnose, especially when there is isolated vertebral body involvement without any soft tissue component, and adjacent disk involvement (6). Therefore, in order to plan appropriate therapy according to the precise diagnosis, the patients are exposed to invasive interventions such as biopsy (2,7,8).…”

Enhancing Box Sign : Enhancement Pattern of Acute Osteoprotic Compression Fracture

“…Acute VCF has a low signal compared with the high signal normally seen in the marrow fat on sagittal T1-weighted sequences in normal vertebrae on MRI 7,[9][10][11]20) . Some authors report that low signal intensity on sagittal T1 represents edema and is related to prognosis 11,21) .…”

“…However, McArdle et al 12) state that T1-weighted images of VCF had normal signals from day 1 through to day 4 and decreased to become a low signal after day 6. In addition, a healing fracture of chronic VCF or heterogeneous fatty marrow can produce a decreased signal on T1-weighted sequences 2,9,14) . Furthermore, hemorrhage, which is an important finding in acute and subacute VCF, may appear as a high signal on T1-weighted images 9,14) .…”

“…In addition, a healing fracture of chronic VCF or heterogeneous fatty marrow can produce a decreased signal on T1-weighted sequences 2,9,14) . Furthermore, hemorrhage, which is an important finding in acute and subacute VCF, may appear as a high signal on T1-weighted images 9,14) . Various reports show that T2-weighted images of the VCF after less than one month have low 2,20) or high signal intensities 20) .…”

MRI diagnosis of intravertebral at fluid osteoporotic and metastatic vertebral compression fractures

“…Первое описание МРТ семиотики ОПКП было сделано 27 лет назад, когда Frager D. et al (1988), обследовав 3 пациентов с из-учением только Т1 взвешенных изображений (ВИ), отметили наличие гипоинтенсивных МР-сигналов в компримированных телах позвонков за счет отека костного мозга (КМ) [12]. В последующих работах приведены разнообразные формы отека при ОПКП, вплоть до диффузного при т.н.…”