Benign vertebral hemangioma: MR-histological correlation

Objective: To explain the magnetic resonance (MR) appearance of benign vert ebral hemangioma by correlating MR and histological findings from autopsy s pecimens. Design: Sagittal T1- and T2-weighted spin-echo images were obtain ed in 83 spine specimens. Focal lesions consistent with vertebral hemangiom a at macroscopic examination of sagittal anatomical sections were sampled f or histological and quantitative analysis. At histology, the proportion of surface area occupied by adipocytes, vessels and edema, and hematopoietic c ells was determined (point-counting method) in normal marrow areas and in l esion areas whose signal intensity was either high and intermediate (patter n A) or intermediate and high (pattern B) on T1- and T2-weighted images, re spectively. Results: Nine lesions were sampled and corresponded to cavernou s hemangioma at histology. The proportion of surface area occupied by adipo cytes was statistically significantly higher in pattern A (78.1%) than in p attern B lesion areas (42.7%) and than in normal marrow areas (47.5%). The proportion of surface area occupied by vessels and interstitial edema was s tatistically significantly higher in pattern B (47.0%) than in pattern A le sion areas (15.5%) and than in normal marrow areas (0). Conclusion: The pre sence of high signal intensity on T1- or T2-weighted images of vertebral he mangioma is related to the amount of adipocytes or vessels and interstitial edema, respectively.