Purpose: To elucidate the MR appearance at different ages of osteoporotic vertebral compression fractures.
Methods: We retrospectively analyzed sequential MR studies of 107 vertebrae in 75 patients with osteoporotic compression fractures.
Results: Vertebral deformities comprised 35 anteriorly wedged vertebrae, 65 fish vertebrae, four flat vertebrae, and others. Signal alterations were depicted as geographic areas of low intensity on T1-weighted images (T1-WI) and high intensity on T2*-WI, or linear areas of low intensity on T1-WI and high or low intensity on T2*-WI. In the acute stage, geographic alteration predominated. During a three-month period following the injuries, the extent of the geographic areas increased in 40% of cases on T1-WI. Geographic alteration declined in the chronic stage, whereas the prevalence of linear signals increased. Restoration of fatty marrow was preceded by linear signals without geographic signals on T1-WI (36%). The anteriorly wedged vertebrae collapsed faster than the fish vertebrae.
Conclusions: The acute or subacute stage of compression fractures is characterized by a larger alteration of the geographic signal, whereas the chronic stage was evidenced by a smaller area of alteration of the geographic and linear signals or by restoration of fatty marrow.