ACUTE VERTEBRAL COLLAPSE DUE TO OSTEOPOROSIS OR MALIGNANCY - APPEARANCE ON UNENHANCED AND GADOLINIUM-ENHANCED MR-IMAGES

PURPOSE: To distinguish malignant from osteoporotic acute vertebral co llapses.MATERIALS AND METHODS: Sixty-three osteoporotic and 30 maligna nt vertebral collapses were studied in 51 patients (aged 33-88 years) with T1-weighted magnetic resonance (MR) images (n = 93), gadolinium-e nhanced T1-weighted images (n = 72), and T2-weighted images (n = 53). RESULTS: Four findings were suggestive of osteoporosis: retropulsion o f a bone fragment (10 osteoporotic cases vs 0 malignant cases), preser vation of normal signal intensity on T1-weighted images (43 vs four), return to normal signal intensity after gadolinium injection (42 vs fo ur) with horizontal bandlike patterns, and isointense vertebrae on T2- weighted images (28 vs two). Six findings were suggestive of malignanc y: convex posterior cortex (21 malignant cases vs four osteoporotic ca ses), 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 i njection (17 vs 0) and on T2-weighted images (17 vs 0). CONCLUSION: Ga dolinium-enhanced and unenhanced MR images are useful in the different iation of vertebral collapses.