Skip to main content
SpringerLink
Log in

Differentiation of Benign and Malignant Vertebral Compression Fractures

  • Chapter
Magnetic Resonance Imaging of the Bone Marrow

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

  • 1595 Accesses

Abstract

The differentiation between acute benign osteoporotic and malignant vertebral fractures is sometimes challenging, since they both occur without adequate trauma and are common in the elderly population. Conventional X-ray is the first imaging method to depict vertebral fractures, however it lacks specificity. CT allows better delineation of osseous destruction in neoplastic fractures, however it is not always possible to define the exact cause of the fracture. MRI is more specific as well as more sensitive in detecting especially discrete osteoporotic fractures. In most cases the combination of morphological signs in CT and MRI allows the determination of a benign or malignant cause of the vertebral fracture. However, there remain uncertain cases with contradictory imaging features. In the following chapter, we discuss the morphological signs which help in the differentiation between acute benign and neoplastic vertebral fractures. We describe the latest techniques such as diffusion-weighted, chemical-shift, and perfusion MRI as well as nuclear-medical techniques.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • An HS, Andreshak TG et al (1995) Can we distinguish between benign versus malignant compression fractures of the spine by magnetic resonance imaging? Spine (Phila Pa 1976) 20(16):1776–1782

    Article  CAS  Google Scholar 

  • Aoki J, Endo K et al (2003) FDG-PET for evaluating musculoskeletal tumors: a review. J Orthop Sci 8(3):435–441

    Article  PubMed  Google Scholar 

  • Baker LL, Goodman SB et al (1990) Benign versus pathologic compression fractures of vertebral bodies: assessment with conventional spin-echo, chemical-shift, and STIR MR imaging. Radiology 174(2):495–502

    PubMed  CAS  Google Scholar 

  • Batson OV (1940) The function of the vertebral veins and their role in the spread of metastases. Ann Surg 112(1):138–149

    Article  PubMed  CAS  Google Scholar 

  • Baur A, Stabler A et al (1997) MRI gadolinium enhancement of bone marrow: age-related changes in normals and in diffuse neoplastic infiltration. Skelet Radiol 26(7):414–418

    Article  CAS  Google Scholar 

  • Baur A, Stabler A et al (1998) Diffusion-weighted MR imaging of bone marrow: differentiation of benign versus pathologic compression fractures. Radiology 207(2):349–356

    PubMed  CAS  Google Scholar 

  • Baur A, Huber A et al (2001) Diagnostic value of increased diffusion weighting of a steady-state free precession sequence for differentiating acute benign osteoporotic fractures from pathologic vertebral compression fractures. Am J Neuroradiol 22(2):366–372

    PubMed  CAS  Google Scholar 

  • Baur A, Huber A et al (2002a) Differentiation of benign osteoporotic and neoplastic vertebral compression fractures with a diffusion-weighted, steady-state free precession sequence. RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin 174(1):70–75

    Article  PubMed  CAS  Google Scholar 

  • Baur A, Stabler A et al (2002b) Acute osteoporotic and neoplastic vertebral compression fractures: fluid sign at MR imaging. Radiology 225(3):730–735

    Article  PubMed  Google Scholar 

  • Baur A, Dietrich O et al (2003) Diffusion-weighted imaging of bone marrow: current status. Eur Radiol 13(7):1699–1708

    Article  PubMed  Google Scholar 

  • Belkoff SM, Molloy S (2003) Temperature measurement during polymerization of polymethylmethacrylate cement used for vertebroplasty. Spine 28(14):1555–1559

    PubMed  Google Scholar 

  • Bhalla S, Reinus WR (1998) The linear intravertebral vacuum: a sign of benign vertebral collapse. Am J Roentgenol 170(6):1563–1569

    CAS  Google Scholar 

  • Biffar A, Baur-Melnyk A et al (2010a) Multiparameter MRI assessment of normal-appearing and diseased vertebral bone marrow. Eur Radiol 20:2679–2689

    Google Scholar 

  • Biffar A, Dietrich O et al (2010b) Diffusion and perfusion imaging of bone marrow. Eur J Radiol 76:323–328

    Google Scholar 

  • Biffar A, Sourbron S et al (2010c) Combined diffusion-weighted and dynamic contrast-enhanced imaging of patients with acute osteoporotic vertebral fractures. Eur J Radiol 76:298–303

    Google Scholar 

  • Biffar A, Sourbron S et al (2010d) Measurement of perfusion and permeability from dynamic contrast-enhanced MRI in normal and pathological vertebral bone marrow. Magn Reson Med 64(1):115–124

    Google Scholar 

  • Biffar A, Schmidt GP et al (2011) Quantitative analysis of vertebral bone marrow perfusion using dynamic contrast-enhanced MRI: initial results in osteoporotic patients with acute vertebral fracture. J Magn Reson Imaging 33(3):676–683

    Article  PubMed  Google Scholar 

  • Bluemke DA, Petri M et al (1995) Femoral head perfusion and composition: MR imaging and spectroscopic evaluation of patients with systemic lupus erythematosus and at risk for avascular necrosis. Radiology 197(2):433–438

    PubMed  CAS  Google Scholar 

  • Brasch RC, Weinmann HJ et al (1984) Contrast-enhanced NMR imaging: animal studies using gadolinium-DTPA complex. Am J Roentgenol 142(3):625–630

    CAS  Google Scholar 

  • Bredella MA, Essary B et al (2008) Use of FDG-PET in differentiating benign from malignant compression fractures. Skelet Radiol 37(5):405–413

    Article  Google Scholar 

  • Brix G, Kiessling F et al (2004) Microcirculation and microvasculature in breast tumors: pharmacokinetic analysis of dynamic MR image series. Magn Reson Med 52(2):420–429

    Article  PubMed  Google Scholar 

  • Brown DB, Gilula LA et al (2004) Treatment of chronic symptomatic vertebral compression fractures with percutaneous vertebroplasty. Am J Roentgenol 182(2):319–322

    Google Scholar 

  • Buchbinder R, Kallmes DF (2010) Vertebroplasty: when randomized placebo-controlled trial results clash with common belief. Spine J (Official journal of the North American Spine Society) 10(3):241–243

    Article  Google Scholar 

  • Buchbinder R, Osborne RH et al (2009) A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med 361(6):557–568

    Article  PubMed  CAS  Google Scholar 

  • Buckley DL, Roberts C et al (2004) Prostate cancer: evaluation of vascular characteristics with dynamic contrast-enhanced T1-weighted MR imaging—initial experience. Radiology 233(3):709–715

    Article  PubMed  Google Scholar 

  • Burge R, Puleo E et al (2002) Inpatient hospital and post-acute care for vertebral fractures in women. Value Health (Journal of the International Society for Pharmacoeconomics and Outcomes Research) 5(4):301–311

    Article  Google Scholar 

  • Castillo M, Arbelaez A et al (2000) Diffusion-weighted MR imaging offers no advantage over routine noncontrast MR imaging in the detection of vertebral metastases. Am J Neuroradiol 21(5):948–953

    PubMed  CAS  Google Scholar 

  • Chan JH, Peh WC et al (2002) Acute vertebral body compression fractures: discrimination between benign and malignant causes using apparent diffusion coefficients. Br J Radiol 75(891):207–214

    PubMed  CAS  Google Scholar 

  • Chen WT, Shih TT et al (2001) Vertebral bone marrow perfusion evaluated with dynamic contrast-enhanced MR imaging: significance of aging and sex. Radiology 220(1):213–218

    PubMed  CAS  Google Scholar 

  • Chen WT, Shih TT et al (2002) Blood perfusion of vertebral lesions evaluated with gadolinium-enhanced dynamic MRI: in comparison with compression fracture and metastasis. J Magn Reson Imaging 15(3):308–314

    Article  PubMed  Google Scholar 

  • Constans JP, de Divitiis E et al (1983) Spinal metastases with neurological manifestations: review of 600 cases. J Neurosurg 59(1):111–118

    Article  PubMed  CAS  Google Scholar 

  • Cuenod CA, Laredo JD et al (1996) Acute vertebral collapse due to osteoporosis or malignancy: appearance on unenhanced and gadolinium-enhanced MR images. Radiology 199(2):541–549

    PubMed  CAS  Google Scholar 

  • Cummings SR, San Martin J et al (2009) Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med 361(8):756–765

    Article  PubMed  CAS  Google Scholar 

  • Cummings SR, Ensrud K et al (2010) Lasofoxifene in postmenopausal women with osteoporosis. N Engl J Med 362(8):686–696

    Article  PubMed  CAS  Google Scholar 

  • Dietrich O, Biffar A et al (2009) Diffusion-weighted imaging of bone marrow. Semin Musculoskelet Radiol 13(2):134–144

    Article  PubMed  Google Scholar 

  • Dusdal K, Grundmanis J et al (2011) Effects of therapeutic exercise for persons with osteoporotic vertebral fractures: a systematic review. Osteoporos Int (Journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA) 22(3):755–769

    Article  CAS  Google Scholar 

  • Eastell R (2007) Breast cancer and the risk of osteoporotic fracture: a paradox. J Clin Endocrinol Metab 92(1):42–43

    Article  PubMed  CAS  Google Scholar 

  • Eito K, Waka S et al (2004) Vertebral neoplastic compression fractures: assessment by dual-phase chemical shift imaging. J Magn Reson Imaging 20(6):1020–1024

    Article  PubMed  Google Scholar 

  • Erlemann R, Reiser M et al (1988) Time-dependent changes in signal intensity in neoplastic and inflammatory lesions of the musculoskeletal system following intravenous administration of Gd-DTPA. Der Radiologe 28(6):269–276

    PubMed  CAS  Google Scholar 

  • Erly WK, Oh ES et al (2006) The utility of in-phase/opposed-phase imaging in differentiating malignancy from acute benign compression fractures of the spine. Am J Neuroradiol 27(6):1183–1188

    PubMed  CAS  Google Scholar 

  • Fornasier VL, Czitrom AA (1978) Collapsed vertebrae: a review of 659 autopsies. Clin Orthop Relat Res 131:261–265

    Google Scholar 

  • Frager D, Elkin C et al (1988) Subacute osteoporotic compression fracture: misleading magnetic resonance appearance. Skelet Radiol 17(2):123–126

    Article  CAS  Google Scholar 

  • Gagnerie F, Taillan B et al (1987) Intravertebral vacuum phenomenon in multiple myeloma. Clin Rheumatol 6(4):597–599

    Article  PubMed  CAS  Google Scholar 

  • Gaitanis IN, Carandang G et al (2005) Restoring geometric and loading alignment of the thoracic spine with a vertebral compression fracture: effects of balloon (bone tamp) inflation and spinal extension. Spine J 5(1):45–54

    Article  PubMed  Google Scholar 

  • Genant HK, Wu CY et al (1993) Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 8(9):1137–1148

    Article  PubMed  CAS  Google Scholar 

  • Gill JB, Kuper M et al (2007) Comparing pain reduction following kyphoplasty and vertebroplasty for osteoporotic vertebral compression fractures. Pain Physician 10(4):583–590

    PubMed  Google Scholar 

  • Golimbu C, Firooznia H et al (1986) The intravertebral vacuum sign. Spine (Phila Pa 1976) 11(10):1040–1043

    Article  CAS  Google Scholar 

  • Griffith JF, Yeung DK et al (2005) Vertebral bone mineral density, marrow perfusion, and fat content in healthy men and men with osteoporosis: dynamic contrast-enhanced MR imaging and MR spectroscopy. Radiology 236(3):945–951

    Article  PubMed  Google Scholar 

  • Guhlmann A, Brecht-Krauss D et al (1998a) Chronic osteomyelitis: detection with FDG PET and correlation with histopathologic findings. Radiology 206(3):749–754

    PubMed  CAS  Google Scholar 

  • Guhlmann A, Brecht-Krauss D et al (1998b) Fluorine-18-FDG PET and technetium-99 m antigranulocyte antibody scintigraphy in chronic osteomyelitis. J Nucl Med 39(12):2145–2152

    PubMed  CAS  Google Scholar 

  • Hacklander T, Scharwachter C et al (2006) Value of diffusion-weighted imaging for diagnosing vertebral metastases due to prostate cancer in comparison to other primary tumors. RoFo: Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin 178(4):416–424

    Article  PubMed  CAS  Google Scholar 

  • Harrington KD (1986) Metastatic disease of the spine. J Bone Joint Surg Am 68(7):1110–1115

    PubMed  CAS  Google Scholar 

  • Hasegawa K, Homma T et al (1998) Vertebral pseudarthrosis in the osteoporotic spine. Spine (Phila Pa 1976) 23(20):2201–2206

    Article  CAS  Google Scholar 

  • Herneth AM, Friedrich K et al (2005) Diffusion weighted imaging of bone marrow pathologies. Eur J Radiol 55(1):74–83

    Article  PubMed  Google Scholar 

  • Hoh CK, Schiepers C et al (1997) PET in oncology: will it replace the other modalities? Semin Nucl Med 27(2):94–106

    Article  PubMed  CAS  Google Scholar 

  • Ishiyama M, Fuwa S et al (2010) Pedicle involvement on MR Imaging is common in osteoporotic compression fractures. Am J Neuroradiol 31(4):668–673

    Article  PubMed  CAS  Google Scholar 

  • Jaquez JA (1985) Compartmental analysis in biology and medicine. The university of Michigan Press, Ann Arbor

    Google Scholar 

  • Jung HS, Jee WH et al (2003) Discrimination of metastatic from acute osteoporotic compression spinal fractures with MR imaging. Radiographics 23(1):179–187

    Article  PubMed  Google Scholar 

  • Kallmes DF, Comstock BA et al (2009) A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med 361(6):569–579

    Article  PubMed  CAS  Google Scholar 

  • Kaplan PA, Orton DF et al (1987) Osteoporosis with vertebral compression fractures, retropulsed fragments, and neurologic compromise. Radiology 165(2):533–535

    PubMed  CAS  Google Scholar 

  • Karchevsky M, Babb JS et al (2008) Can diffusion-weighted imaging be used to differentiate benign from pathologic fractures? a meta-analysis. Skelet Radiol 37(9):791–795

    Article  Google Scholar 

  • Kato K, Aoki J et al (2003) Utility of FDG-PET in differential diagnosis of benign and malignant fractures in acute to subacute phase. Ann Nucl Med 17(1):41–46

    Article  PubMed  Google Scholar 

  • Kondo KL (2008) Osteoporotic vertebral compression fractures and vertebral augmentation. Sem Intervent Radiol 25(4):413–424

    Article  Google Scholar 

  • Kubota T, Yamada K et al (2005) High-resolution imaging of the spine using multidetector-row computed tomography: differentiation between benign and malignant vertebral compression fractures. J Comput Assist Tomogr 29(5):712–719

    Article  PubMed  Google Scholar 

  • Kumpan W, Salomonowitz E et al (1986) The intravertebral vacuum phenomenon. Skelet Radiol 15(6):444–447

    Article  CAS  Google Scholar 

  • Lafforgue P, Chagnaud C et al (1997) The intravertebral vacuum phenomenon (“vertebral osteonecrosis”): migration of intradiscal gas in a fractured vertebral body. Spine (Phila Pa 1976) 22(16):1885–1891

    Article  CAS  Google Scholar 

  • Laredo JD, Lakhdari K et al (1995) Acute vertebral collapse: CT findings in benign and malignant nontraumatic cases. Radiology 194(1):41–48

    PubMed  CAS  Google Scholar 

  • Le Bihan DJ (1998) Differentiation of benign versus pathologic compression fractures with diffusion-weighted MR imaging: a closer step toward the “holy grail” of tissue characterization? Radiology 207(2):305–307

    PubMed  CAS  Google Scholar 

  • Lecouvet FE, Vande Berg BC et al (1997) Vertebral compression fractures in multiple myeloma: part I: distribution and appearance at MR imaging. Radiology 204(1):195–199

    PubMed  CAS  Google Scholar 

  • Leeds NE, Kumar AJ et al (2000) Magnetic resonance imaging of benign spinal lesions simulating metastasis: role of diffusion-weighted imaging. Top Magn Reson Imaging 11(4):224–234

    Article  PubMed  CAS  Google Scholar 

  • Lieberman IH, Dudeney S et al (2001) Initial outcome and efficacy of “kyphoplasty” in the treatment of painful osteoporotic vertebral compression fractures. Spine 26(14):1631–1638

    Article  PubMed  CAS  Google Scholar 

  • Link TM, Guglielmi G et al (2005) Radiologic assessment of osteoporotic vertebral fractures: diagnostic and prognostic implications. Eur Radiol 15(8):1521–1532

    Article  PubMed  Google Scholar 

  • Linn J, Birkenmaier C et al (2009) The intravertebral cleft in acute osteoporotic fractures: fluid in magnetic resonance imaging-vacuum in computed tomography? Spine 34(2):E88–E93

    Article  PubMed  Google Scholar 

  • Lips P, Bouillon R et al (2010) Reducing fracture risk with calcium and vitamin D. Clin Endocrinol 73(3):277–285

    Article  CAS  Google Scholar 

  • MacLean C, Newberry S et al (2008) Systematic review: comparative effectiveness of treatments to prevent fractures in men and women with low bone density or osteoporosis. Ann Intern Med 148(3):197–213

    PubMed  Google Scholar 

  • Malghem J, Maldague B et al (1993) Intravertebral vacuum cleft: changes in content after supine positioning. Radiology 187(2):483–487

    PubMed  CAS  Google Scholar 

  • Masala S, Schillaci O et al (2005) MRI and bone scan imaging in the preoperative evaluation of painful vertebral fractures treated with vertebroplasty and kyphoplasty. In Vivo 19(6):1055–1060

    PubMed  Google Scholar 

  • Melton LJ (1997) Epidemiology of spinal osteoporosis. Spine (Phila Pa 1976) 22(24 Suppl):2S–11S

    Article  Google Scholar 

  • Metser U, Lerman H et al (2004) Malignant involvement of the spine: assessment by 18F-FDG PET/CT. J Nucl Med 45(2):279–284

    PubMed  Google Scholar 

  • Meunier PJ, Roux C et al (2004) The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med 350(5):459–468

    Article  PubMed  CAS  Google Scholar 

  • Montazel JL, Divine M et al (2003) Normal spinal bone marrow in adults: dynamic gadolinium-enhanced MR imaging. Radiology 229(3):703–709

    Article  PubMed  Google Scholar 

  • Moulopoulos LA, Yoshimitsu K et al (1996) MR prediction of benign and malignant vertebral compression fractures. J Magn Reson Imaging 6(4):667–674

    Article  PubMed  CAS  Google Scholar 

  • Moulopoulos LA, Dimopoulos MA et al (1999) Bone lesions with soft-tissue mass: magnetic resonance imaging diagnosis of lymphomatous involvement of the bone marrow versus multiple myeloma and bone metastases. Leuk Lymph 34(1–2):179–184

    CAS  Google Scholar 

  • O’Neill TW, Felsenberg D et al (1996) The prevalence of vertebral deformity in European men and women: the European vertebral osteoporosis study. J Bone Miner Res (Official journal of the American Society for Bone and Mineral Research) 11(7):1010–1018

    Article  Google Scholar 

  • Oztekin O, Ozan E et al (2009) SSH-EPI diffusion-weighted MR imaging of the spine with low b values: is it useful in differentiating malignant metastatic tumor infiltration from benign fracture edema? Skelet Radiol 38(7):651–658

    Article  Google Scholar 

  • Palmer WE, Rosenthal DI et al (1995) Quantification of inflammation in the wrist with gadolinium-enhanced MR imaging and PET with 2-[F-18]-fluoro-2-deoxy-d-glucose. Radiology 196(3):647–655

    PubMed  CAS  Google Scholar 

  • Park SW, Lee JH et al (2004) Single shot fast spin echo diffusion-weighted MR imaging of the spine; is it useful in differentiating malignant metastatic tumor infiltration from benign fracture edema? Clin Imaging 28(2):102–108

    Article  PubMed  Google Scholar 

  • Pfeifer M, Begerow B et al (2004) Effects of a new spinal orthosis on posture, trunk strength, and quality of life in women with postmenopausal osteoporosis: a randomized trial. Am J Phys Med Rehabil / Assoc Acad Physiatrists 83(3):177–186

    Article  Google Scholar 

  • Prather H, Watson JO et al (2007) Nonoperative management of osteoporotic vertebral compression fractures. Injury 38(Suppl 3):S40–S48

    Article  PubMed  Google Scholar 

  • Ragab Y, Emad Y et al (2009) Differentiation of osteoporotic and neoplastic vertebral fractures by chemical shift in-phase and out-of phase MR imaging. Eur J Radiol 72(1):125–133

    Article  PubMed  Google Scholar 

  • Resnick D, Niwayama G et al (1981) Spinal vacuum phenomena: anatomical study and review. Radiology 139(2):341–348

    PubMed  CAS  Google Scholar 

  • Rupp RE, Ebraheim NA et al (1995) Magnetic resonance imaging differentiation of compression spine fractures or vertebral lesions caused by osteoporosis or tumor. Spine (Phila Pa 1976) 20(23):2499–2503 discussion 2504

    Article  CAS  Google Scholar 

  • Sartoris DJ, Clopton P et al (1986) Vertebral-body collapse in focal and diffuse disease: patterns of pathologic processes. Radiology 160(2):479–483

    PubMed  CAS  Google Scholar 

  • Sattari A, Quillard A et al (2008) Benign nontraumatic osteolytic vertebral collapse simulating malignancy. Eur Radiol 18(3):631–638

    Article  PubMed  Google Scholar 

  • Savvopoulou V, Maris TG et al (2008) Differences in perfusion parameters between upper and lower lumbar vertebral segments with dynamic contrast-enhanced MRI (DCE MRI). Eur Radiol 18(9):1876–1883

    Article  PubMed  Google Scholar 

  • Schmitz A, Risse JH et al (2002) FDG-PET findings of vertebral compression fractures in osteoporosis: preliminary results. Osteoporos Int 13(9):755–761

    Article  PubMed  Google Scholar 

  • Shih TT, Huang KM et al (1999) Solitary vertebral collapse: distinction between benign and malignant causes using MR patterns. J Magn Reson Imaging 9(5):635–642

    Article  PubMed  CAS  Google Scholar 

  • Silverman SL, Christiansen C et al (2008) Efficacy of bazedoxifene in reducing new vertebral fracture risk in postmenopausal women with osteoporosis: results from a 3-year, randomized, placebo-, and active-controlled clinical trial. J Bone Miner Res (Official journal of the American Society for Bone and Mineral Research) 23(12):1923–1934

    Article  CAS  Google Scholar 

  • Stäbler A, Schneider P et al (1999) Intravertebral vacuum phenomenon following fractures: CT study on frequency and etiology. J Comput Assist Tomogr 23(6):976–980

    Article  PubMed  Google Scholar 

  • Stadhouder A, Buskens E et al (2009) Nonoperative treatment of thoracic and lumbar spine fractures: a prospective randomized study of different treatment options. J Orthop Trauma 23(8):588–594

    Article  PubMed  Google Scholar 

  • Strauss LG, Conti PS (1991) The applications of PET in clinical oncology. J Nucl Med 32(4):623–648 discussion 649–650

    PubMed  CAS  Google Scholar 

  • Sugimoto T, Tanigawa N et al (2008) Diffusion-weighted imaging for predicting new compression fractures following percutaneous vertebroplasty. Acta Radiol 49(4):419–426

    Article  PubMed  CAS  Google Scholar 

  • Tan SB, Kozak JA et al (1991) The limitations of magnetic resonance imaging in the diagnosis of pathologic vertebral fractures. Spine (Phila Pa 1976) 16(8):919–923

    Article  CAS  Google Scholar 

  • Tancioni F, Lorenzetti MA et al (2011) Percutaneous vertebral augmentation in metastatic disease: state of the art. J Support Oncol 9(1):4–10

    Article  PubMed  Google Scholar 

  • Tang G, Liu Y et al (2007) Optimization of b value in diffusion-weighted MRI for the differential diagnosis of benign and malignant vertebral fractures. Skelet Radiol 36(11):1035–1041

    Article  Google Scholar 

  • Tanigawa N, Komemushi A et al (2006) Percutaneous vertebroplasty: relationship between vertebral body bone marrow edema pattern on MR images and initial clinical response. Radiology 239(1):195–200

    Article  PubMed  Google Scholar 

  • Taoka T, Mayr NA et al (2001) Factors influencing visualization of vertebral metastases on MR imaging versus bone scintigraphy. Am J Roentgenol 176(6):1525–1530

    CAS  Google Scholar 

  • Thariat J, Toubeau M et al (2004) Sensitivity and specificity of thallium-201 scintigraphy for the diagnosis of malignant vertebral fractures. Eur J Radiol 51(3):274–278

    Article  PubMed  Google Scholar 

  • Thurnher MM, Bammer R (2006) Diffusion-weighted magnetic resonance imaging of the spine and spinal cord. Semin Roentgenol 41(4):294–311

    Article  PubMed  Google Scholar 

  • Tofts PS, Brix G et al (1999) Estimating kinetic parameters from dynamic contrast-enhanced T(1)-weighted MRI of a diffusable tracer: standardized quantities and symbols. J Mag Res Imaging 10(3):223–232

    Article  CAS  Google Scholar 

  • Tokuda O, Hayashi N et al (2005) Dynamic contrast-enhanced perfusion MR imaging of diseased vertebrae: analysis of three parameters and the distribution of the time-intensity curve patterns. Skelet Radiol 34(10):632–638

    Article  Google Scholar 

  • Tokuda O, Harada Y et al (2011) Malignant versus benign vertebral compression fractures: can we use bone SPECT as a substitute for MR imaging? Nucl Med Commun 32(3):192–198

    Article  PubMed  Google Scholar 

  • Uetani M, Hashmi R et al (2004) Malignant and benign compression fractures: differentiation and diagnostic pitfalls on MRI. Clin Radiol 59(2):124–131

    Article  PubMed  CAS  Google Scholar 

  • Uppin AA, Hirsch JA et al (2003) Occurrence of new vertebral body fracture after percutaneous vertebroplasty in patients with osteoporosis. Radiology 226(1):119–124

    Article  PubMed  Google Scholar 

  • Vaccaro AR, Shah SH et al (1999) MRI description of vertebral osteomyelitis, neoplasm, and compression fracture. Orthopedics 22(1):67–73 quiz 74-65

    PubMed  CAS  Google Scholar 

  • van der Klift M, de Laet CE et al (2004) Risk factors for incident vertebral fractures in men and women: the Rotterdam study. J Bone Miner Res (Official journal of the American Society for Bone and Mineral Research) 19(7):1172–1180

    Article  Google Scholar 

  • Vande Berg BC, Malghem J et al (1998) Magnetic resonance imaging of the normal bone marrow. Skelet Radiol 27(9):471–483

    Article  Google Scholar 

  • Vogler JB III, Murphy WA (1988) Bone marrow imaging. Radiology 168(3):679–693

    PubMed  Google Scholar 

  • Voormolen MH, van Rooij WJ et al (2006) Pain response in the first trimester after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures with or without bone marrow edema. Am J Neuroradiol 27(7):1579–1585

    PubMed  CAS  Google Scholar 

  • Wasnich RD (1996) Vertebral fracture epidemiology. Bone 18(3 Suppl):179S–183S

    Article  PubMed  CAS  Google Scholar 

  • White AP, Kwon BK et al (2006) Metastatic disease of the spine. J Am Acad Orthop Surg 14(11):587–598

    PubMed  Google Scholar 

  • Yuh WT, Zachar CK et al (1989) Vertebral compression fractures: distinction between benign and malignant causes with MR imaging. Radiology 172(1):215–218

    PubMed  CAS  Google Scholar 

  • Zajick DC Jr, Morrison WB et al (2005) Benign and malignant processes: normal values and differentiation with chemical shift MR imaging in vertebral marrow. Radiology 237(2):590–596

    Article  PubMed  Google Scholar 

  • Zhou XJ, Leeds NE et al (2002) Characterization of benign and metastatic vertebral compression fractures with quantitative diffusion MR imaging. Am J Neuroradiol 23(1):165–170

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institut für Klinische Radiologie, Klinikum der Universität Munchen-Großhadern, Marchioninistraße 15, 81377, Munich, Germany

    Andrea Baur-Melnyk & Tobias Geith

Authors
  1. Andrea Baur-Melnyk
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tobias Geith
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrea Baur-Melnyk .

Editor information

Editors and Affiliations

  1. , Institut für Klinische Radiologie, Klinikum der Universität München (Großha, Marchioninistraße 15, München, 81377, Germany

    Andrea Baur-Melnyk

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Baur-Melnyk, A., Geith, T. (2013). Differentiation of Benign and Malignant Vertebral Compression Fractures. In: Baur-Melnyk, A. (eds) Magnetic Resonance Imaging of the Bone Marrow. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2011_493

Download citation

  • DOI: https://doi.org/10.1007/174_2011_493

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-17859-7

  • Online ISBN: 978-3-642-17860-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation