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Characterization of Benign and Metastatic Vertebral Compression Fractures with Quantitative Diffusion MR Imaging

Xiaohong Joe Zhoua, Norman E. Leedsa, Graeme C. McKinnonb and Ashok J. Kumara

a Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston, TX
b Applied Science Laboratory, GE Medical Systems, Milwaukee, WI



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  		FIG 1. Acute osteopenic compression fracture of the L1 vertebral body simulating metastasis. The mean ADC value of the lesion is 2.8 x 10-4 mm2/s.

A, Sagittal T1-weighted MR image (600/8; section thickness, 5 mm; intersection spacing, 1 mm; FOV, 32 cm; matrix, 512 x 512) shows the lesion as diffusely hypointense (arrow). Typical appearance of benign compression fracture involves the T12 vertebral body, with a bandlike area of abnormal signal intensity (arrowhead).

B, Sagittal T2-weighted fat-suppressed MR image (3000/99; section thickness, 5 mm; intersection spacing, 1 mm; FOV, 32 cm) shows the lesion as hyperintense (arrow). Typical appearance of benign compression fracture involves the T12 vertebral body, with a bandlike area of abnormal signal intensity (arrowhead).

C, Sagittal contrast-enhanced T1-weighted fat-suppressed MR image (416/8.3; section thickness, 5 mm; intersection spacing, 1 mm; FOV, 32 cm) shows the lesion as enhanced (arrow). Typical appearance of benign compression fracture involves the T12 vertebral body, with horizontal bandlike enhancement paralleling the endplate (arrowhead).

D, Sagittal diffusion-weighted MR image (5000/96.4; bandwidth, 125 kHz; FOV, 32 cm; matrix, 128 x 128; section thickness, 5 mm; intersection spacing, 1 mm) shows the lesion as hyperintense (arrow). Benign compression fracture is mildly hyperintense (arrowhead).



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  		FIG 2. Typical MR images of the L2 vertebral body metastasis with pathologic fractures reveal a sharply defined lytic lesion. The lesion has a mean ADC value of 1.7 x 10-4 mm2/s.

A, Sagittal T1-weighted image (650/12; section thickness, 4 mm; intersection spacing, 1 mm; FOV, 32 cm; matrix, 512 x 512) shows low signal intensity (arrow).

B, Sagittal T2-weighted fat-suppressed image (3000/99; section thickness, 4 mm; intersection spacing, 1–2 mm; FOV, 28–36 cm) shows heterogeneous abnormal signal intensity (arrow).

C, Sagittal contrast-enhanced T1-weighted fat-suppressed image (416/12; section thickness, 4–6 mm; intersection spacing, 1 mm; FOV, 32 cm) shows enhancement (arrow).

D, Sagittal diffusion-weighted image (5000/96.4; bandwidth, 125 kHz; FOV, 36 cm; matrix, 128 x 128; section thickness, 7.5 mm; intersection spacing, 1 mm) shows the lesion as bright area (arrow).



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  		FIG 3. Histograms of ADC values for benign fractures (circles) and metastases (diamonds) in the vertebral bodies.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X