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  • Title: [The nuclear magnetic resonance tomographic differentiation of osteoporotic and tumor-related vertebral fractures. The value of subtractive TR gradient-echo sequences, STIR sequences and Gd-DTPA].
    Author: Stäbler A, Krimmel K, Seiderer M, Gärtner C, Fritsch S, Raum W.
    Journal: Rofo; 1992 Sep; 157(3):215-21. PubMed ID: 1391814.
    Abstract:
    42 patients with known malignancy and vertebral compressions underwent MRI. Sagittal T1-weighted spin-echo images pre and post Gd-DTPA, out of phase long TR gradient-echo images (GE) and short T1 inversion recovery images (STIR) were obtained at 1.0 T. The results were confirmed by histology (6/42) or clinical data (28/42) and follow up MRI studies (8/42). In 39 of 42 cases a correct differentiation between osteoporotic and tumorous vertebral compression fractures was possible by quantification and correlation of SE and GE signal intensities. Gd-DTPA did not improve differential diagnosis, since both tumour infiltration and bone marrow oedema in acute compression fracture showed comparable enhancement. STIR-sequences were most sensitive for pathology but unspecific due to a comparable amount of water in tumour tissue and bone marrow oedema. Susceptibility-induced signal reduction in GE images and morphologic criteria proved to be most reliable for differentiation of benign and tumour-related fractures. In the rare cases of single and nearly complete vertebral compressions with complete loss of bone marrow, differentiation with MRI was not possible.
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