Blood perfusion of vertebral lesions evaluated with gadolinium-enhanced dynamic MRI: In comparison with compression fracture and metastasis

• Published in: Journal of magnetic resonance imaging 2002-03, Vol.15 (3), p.308-314
• Main Authors: Chen, Wei-Tsung, Shih, Tiffany Ting-Fang, Chen, Ran-Chou, Lo, Hsin-Yen, Chou, Chen-Te, Lee, Jiunn-Ming, Tu, Hsing-Yang
• Format: Article
• Language: English
• Subjects: Adult; Aged; compression fracture; Contrast Media; Diagnosis, Differential; Female; Fractures, Spontaneous - etiology; Fractures, Spontaneous - pathology; Gadolinium DTPA; Gd-DTPA-enhanced dynamic MR; Humans; Image Enhancement; Magnetic Resonance Imaging - methods; Male; metastasis; Middle Aged; Neoplasm Metastasis; pathologic fracture; Spinal Fractures - etiology; Spinal Fractures - pathology; Spinal Neoplasms - blood supply; Spinal Neoplasms - pathology; Spinal Neoplasms - secondary; Spine - pathology; time-intensity curve
• ISSN: 1053-1807; 1522-2586
• DOI: 10.1002/jmri.10063

Purpose To investigate blood perfusion of vertebral lesions using dynamic Gd‐DTPA‐enhanced MRI. Materials and Methods Dynamic MR studies were performed for cases of acute compression fracture, chronic compression fracture, metastatic vertebral lesions with or without compression fracture. A total of 42 patients (71 vertebral segments) were included. Five types of time‐intensity curves (TICs) were defined as: nearly no enhancement (type A), slow enhancement (type B), a rapid contrast wash‐in followed by an equilibrium phase (type C), a rapid contrast wash‐in followed by early wash‐out (type D), and a rapid contrast wash‐in with a second slower‐rising slope (type E). Results Metastatic vertebral lesions with or without fracture had a higher peak enhancement percentage and steeper enhancement slope than those of chronic compression fracture, but had no difference as compared to those of acute compression fracture. The type D curve had high positive predictive value for metastatic group (100%), and the type E curve had high positive predictive value for benign compression fracture (85.7%). Conclusion Type D and E curves are valuable in the differentiation of benign and malignant vertebral lesions. J. Magn. Reson. Imaging 2002;15:308–314. © 2002 Wiley‐Liss, Inc.