Solitary vertebral collapse: distinction between benign and malignant causes using MR patterns

J Magn Reson Imaging. 1999 May;9(5):635-42. doi: 10.1002/(sici)1522-2586(199905)9:5<635::aid-jmri4>;2-e.


Differentiation of benign from malignant causes of vertebral compression fracture can be difficult at a single location. We studied 37 patients with solitary vertebral collapse (SVC) in the spine using magnetic resonance imaging (MRI). Sixteen of them were found to have a benign cause of SVC, while the remaining 21 were found to have malignancy. The following four MRI characteristics were investigated: ill- or well-defined margin of the intravertebral lesion (P < 0.005); pedicle involvement (P < 0.05); MR enhancement pattern (P < 0.005); and paravertebral soft tissue lesion (PSL) (P < 0.025). It was found that cases of malignant SVC tended to have an ill-defined margin, abnormal signal involvement of the pedicle, a marked and heterogenous MR enhancement pattern, and irregular nodular-type PSL. Pedicle change with expansile lesion totally excluded a benign cause. By using these criteria, we were able to differentiate benign or malignant causes of SVC accurately.

MeSH terms

  • Aged
  • Case-Control Studies
  • Diagnosis, Differential
  • Female
  • Fractures, Spontaneous / diagnosis*
  • Fractures, Spontaneous / etiology
  • Humans
  • Lumbar Vertebrae / pathology*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Spinal Diseases / complications*
  • Spinal Fractures / diagnosis*
  • Spinal Fractures / etiology
  • Spinal Neoplasms / complications
  • Spinal Neoplasms / secondary*
  • Thoracic Vertebrae / pathology