Acute vertebral collapse due to osteoporosis or malignancy: appearance on unenhanced and gadolinium-enhanced MR images

Radiology. 1996 May;199(2):541-9. doi: 10.1148/radiology.199.2.8668809.


Purpose: To distinguish malignant from osteoporotic acute vertebral collapses.

Materials and methods: Sixty-three osteoporotic and 30 malignant vertebral collapses were studied in 51 patients (aged 33-88 years) with T1-weighted magnetic resonance (MR) images (n=93), gadolinium-enhanced T1-weighted images (n=72), and T2-weighted images (n=53).

Results: Four findings were suggestive of osteoporosis: retropulsion of a bone fragment (10 osteoporotic cases vs 0 malignant cases), preservation of normal signal intensity on T1-weighted images (43 vs four), return to normal signal intensity after gadolinium injection (42 vs four) with horizontal bandlike patterns, and isointense vertebrae on T2-weighted images (28 vs two). Six findings were suggestive of malignancy: convex posterior cortex (21 malignant cases vs four osteoporotic cases), epidural mass (24 vs 0), diffuse low signal intensity within the vertebral body on T1-weighted images (23 vs 12) and in the pedicles (24 vs four), high or inhomogeneous signal intensity after gadolinium injection (17 vs 0) and on T2-weighted images (17 vs 0).

Conclusion: Gadolinium-enhanced and unenhanced MR images are useful in the differentiation of vertebral collapses.

Publication types

  • Comparative Study

MeSH terms

  • Acute Disease
  • Contrast Media
  • Diagnosis, Differential
  • Female
  • Fractures, Spontaneous / diagnosis*
  • Fractures, Spontaneous / etiology*
  • Heterocyclic Compounds*
  • Humans
  • Logistic Models
  • Lumbar Vertebrae / injuries*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Organometallic Compounds*
  • Osteoporosis / complications*
  • Osteoporosis / diagnosis
  • Predictive Value of Tests
  • Retrospective Studies
  • Sensitivity and Specificity
  • Spinal Fractures / diagnosis*
  • Spinal Fractures / etiology*
  • Spinal Neoplasms / complications*
  • Spinal Neoplasms / diagnosis
  • Spinal Neoplasms / secondary
  • Thoracic Vertebrae / injuries*


  • Contrast Media
  • Heterocyclic Compounds
  • Organometallic Compounds
  • gadolinium 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetate