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

Differentiation of benign from malignant causes of vertebral compression fr acture can be difficult at a single location, We studied 37 patients with s olitary vertebral collapse (SVC) in the spine using magnetic resonance imag ing (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 char acteristics were investigated: ill- or well-defined margin of the intravert ebral lesion (P < 0.005); pedicle involvement (P < 0.05); MR enhancement pa ttern (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 marg in, abnormal signal involvement of the pedicle, a marked and heterogenous M R 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 , (C) 1999 Wiley-Liss, Inc.