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PubMedDate not supplied

Discrimination of metastatic from acute osteoporotic compression spinal fractures with MR imaging.

A study was performed to determine which magnetic resonance (MR) imaging findings are useful in discrimination between metastatic compression fractures and acute osteoporotic compression fractures of the spine. The MR imaging findings in 27 patients with metastatic compression fractures and 55 patients with acute osteoporotic compression fractures were compared by using the chi(2) test. MR imaging findings suggestive of metastatic compression fractures were as follows: a convex posterior border of the vertebral body, abnormal signal intensity of the pedicle or posterior element, an epidural mass, an encasing epidural mass, a focal paraspinal mass, and other spinal metastases. MR imaging findings suggestive of acute osteoporotic compression fractures were as follows: a low-signal-intensity band on T1- and T2-weighted images, spared normal bone marrow signal intensity of the vertebral body, retropulsion of a posterior bone fragment, and multiple compression fractures. The signal intensity on fast spin-echo T2-weighted images obtained without fat suppression played little role in distinguishing between metastatic compression fractures and acute osteoporotic compression fractures.

Acute Disease↗
PubMedDate not supplied

Spinal fractures and pseudoarthrosis complicating ankylosing spondylitis: MRI manifestation and clinical significance.

PURPOSE: To analyze magnetic resonance (MR) patterns of fractures and pseudoarthrosis of the ankylosing spondylitic spine, and related changes in the dura and adjacent soft tissue. MATERIALS AND METHODS: Sixteen patients with radiographically evident fractures or pseudoarthrosis of the spine were included. Each underwent MR studies. Ten patients among them underwent surgical operations. RESULTS: Both transdiscal (n = 12) and transvertebral (n = 4) fractures were identified. The levels were located from T9 to L3. Five of 16 patients had pseudoarthrosis. The fractures or pseudoarthrosis had two patterns: low signal on T1-and high signal on T2-weighted images, and low signal on both T1-and T2-weighted images. Disruption of anterior longitudinal ligament (ALL) was identified in 14 patients. Seven patients had vertebral translation, all had disruption of the ALL. Dural adhesions were noted in five patients and manifested as linear epidural enhancements with triangular blunt edges. CONCLUSION: MR patterns of ankylosing spondylitis are important in evaluating complications of fractures or pseudoarthrosis, as well as changes in dura, soft tissue, and ligaments.

Adult↗