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Research ArticleSpine
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Differentiating Atypical Hemangiomas and Metastatic Vertebral Lesions: The Role of T1-Weighted Dynamic Contrast-Enhanced MRI

K.A. Morales, J. Arevalo-Perez, K.K. Peck, A.I. Holodny, E. Lis and S. Karimi
American Journal of Neuroradiology May 2018, 39 (5) 968-973; DOI: https://doi.org/10.3174/ajnr.A5630
K.A. Morales
aFrom the Departments of Radiology (K.A.M., J.A.-P., K.K.P., A.I.H., E.L., S.K.)
cUniversity of Puerto Rico Medical Sciences Campus (K.A.M.), San Juan, Puerto Rico.
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J. Arevalo-Perez
aFrom the Departments of Radiology (K.A.M., J.A.-P., K.K.P., A.I.H., E.L., S.K.)
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K.K. Peck
aFrom the Departments of Radiology (K.A.M., J.A.-P., K.K.P., A.I.H., E.L., S.K.)
bMedical Physics (K.K.P.), Memorial Sloan Kettering Cancer Center, New York, New York
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A.I. Holodny
aFrom the Departments of Radiology (K.A.M., J.A.-P., K.K.P., A.I.H., E.L., S.K.)
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E. Lis
aFrom the Departments of Radiology (K.A.M., J.A.-P., K.K.P., A.I.H., E.L., S.K.)
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S. Karimi
aFrom the Departments of Radiology (K.A.M., J.A.-P., K.K.P., A.I.H., E.L., S.K.)
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    Fig 1.

    Representative sagittal T1-weighted and dynamic images derived from DCE MR imaging for atypical hemangiomas and spinal lesions originating from primary breast and lung carcinomas. The lower panel corresponds to the MR imaging signal enhancement curve as a function of phases (time) obtained for each representative lesion shown.

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    Fig 2.

    A, Enhancement curve for all 34 atypical hemangiomas. Curves highlighted in cyan show the 4 cases with elevated enhancement. B, Average enhancement curves for all atypical hemangiomas (cyan) excluding atypical hemangiomas with elevated enhancement (blue). C, Average enhancement curves for all atypical hemangiomas excluding enhancement curve outliers (blue) compared with breast (red) and lung (green) metastases.

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    Fig 3.

    Representative sagittal T1-weighted imaging and the corresponding perfusion maps for Vp and Ktrans parameters for atypical hemangiomas and metastasis from lung carcinoma. Arrows indicate the level of the lesion in T1WI, and the cyan circle highlights the region on Vp and Ktrans maps where the lesion is located.

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    Fig 4.

    Vp and Ktrans parameters obtained for atypical hemangiomas and metastatic lesions from breast and lung carcinoma. Metastases show significantly higher values (P < .05) for both Vp and Ktrans compared with atypical vertebral hemangiomas. Note that the 4 outlier values representing aggressive hemangiomas account for the higher Vp values in the atypical hemangioma group that demonstrate minimal overlap with the metastatic group and remain low compared with other metastases.

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American Journal of Neuroradiology: 39 (5)
American Journal of Neuroradiology
Vol. 39, Issue 5
1 May 2018
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Cite this article
K.A. Morales, J. Arevalo-Perez, K.K. Peck, A.I. Holodny, E. Lis, S. Karimi
Differentiating Atypical Hemangiomas and Metastatic Vertebral Lesions: The Role of T1-Weighted Dynamic Contrast-Enhanced MRI
American Journal of Neuroradiology May 2018, 39 (5) 968-973; DOI: 10.3174/ajnr.A5630

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Differentiating Atypical Hemangiomas and Metastatic Vertebral Lesions: The Role of T1-Weighted Dynamic Contrast-Enhanced MRI
K.A. Morales, J. Arevalo-Perez, K.K. Peck, A.I. Holodny, E. Lis, S. Karimi
American Journal of Neuroradiology May 2018, 39 (5) 968-973; DOI: 10.3174/ajnr.A5630
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