Abstract
Establishing whether the cause of an acute vertebral compression fracture (VCF) is benign or malignant has important clinical implications and can often be challenging. This is especially true in elderly patients who are prone to develop osteoporosis-related fractures but are also more likely to carry an undiagnosed malignancy, as well as in cancer patients with no known bone metastases who present with an acute VCF. Traumatic vertebral fractures, which do not pose a differential diagnosis problem, will not be addressed in this chapter.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Mathis JM, Barr JD, Belkoff SM et al (2001) Percutaneous vertebroplasty: a developing standard of care for vertebral compression fractures. AJNR Am J Neuroradiol 22:373–381
Thawait SK, Marcus MA, Morrison WB et al (2012) Research synthesis: what is the diagnostic performance of magnetic resonance imaging to discriminate benign from malignant vertebral compression fractures? Systematic review and meta-analysis. Spine (Phila Pa 1976) 37:E736–E744
Cooper C, Melton LJ (1992) Vertebral fractures. BMJ 304:793–794
Papaioannou A, Watts NB, Kendler DL et al (2002) Diagnosis and management of vertebral fractures in elderly adults. Am J Med 113:220–228
Melton LJ, Kan SH, Frye MA et al (1989) Epidemiology of vertebral fractures in women. Am J Epidemiol 129:1000–1011
Bartalena T, Rinaldi MF, Modolon C et al (2010) Incidental vertebral compression fractures in imaging studies: lessons not learned by radiologists. World J Radiol 2:399–404
Carberry GA, Pooler BD, Binkley N et al (2013) Unreported vertebral body compression fractures at abdominal multidetector CT. Radiology 268:120–126
Faciszewski T, McKiernan F (2002) Calling all vertebral fractures classification of vertebral compression fractures: a consensus for comparison of treatment and outcome. J Bone Miner Res 17:185–191
Jung HS, Jee WH, McCauley TR (2003) Discrimination of metastatic from acute osteoporotic compression spinal fractures with MR imaging. Radiographics 23:179–187
Laredo JD, Lakhdari K, Bellaïche L et al (1995) Acute vertebral collapse: CT findings in benign and malignant nontraumatic cases. Radiology 194:41–48
Uetani M, Hashmi R, Hayashi K (2004) Malignant and benign compression fractures: differentiation and diagnostic pitfalls on MRI. Clin Radiol 59:124–131
Crandall D, Slaughter D, Hankins PJ et al (2004) Acute versus chronic vertebral compression fractures treated with kyphoplasty: early results. Spine J 4:418–424
Cuénod CA, Laredo JD, Chevret S et al (1996) Acute vertebral collapse due to osteoporosis or malignancy: appearance on unenhanced and gadolinium-enhanced MR images. Radiology 199:541–549
Moulopoulos LA, Yoshimitsu K, Johnston DA et al (1996) MR prediction of benign and malignant vertebral compression fractures. J Magn Reson Imaging 6:667–674
Yuh WT, Zachar CK, Barloon TJ et al (1989) Vertebral compression fractures: distinction between benign and malignant causes with MR imaging. Radiology 172:215–218
McNeil BJ (1984) Value of bone scanning in neoplastic disease. Semin Nucl Med 14(4):277–286
Lecouvet FE, Vande Berg BC, Maldague BE et al (1997) Vertebral compression fractures in multiple myeloma. Part I. Distribution and appearance at MR imaging. Radiology 204:195–199
Fornasier V, Czitron A (1978) Collapsed vertebrae: a review of 659 autopsies. Clin Orthop 131:261–265
Theodorou DJ (2001) The intravertebral vacuum cleft sign. Radiology 221:787–788
Malghem J, Maldague B, Labaisse MA et al (1993) Intravertebral vacuum cleft: changes in content after supine positioning. Radiology 187:483–487
Baur A, Stäbler A, Arbogast S et al (2002) Acute osteoporotic and neoplastic vertebral compression fractures: fluid sign at MR imaging. Radiology 225:730–735
Libicher M, Appelt A, Berger I et al (2007) The intravertebral vacuum phenomenon as specific sign of osteonecrosis in vertebral compression fractures: results from a radiological and histological study. Eur Radiol 17:2248–2252
Feng SW, Chang MC, Wu HT et al (2011) Are intravertebral vacuum phenomena benign lesions? Eur Spine J 20:1341–1348
Stäbler A, Schneider P, Link TM et al (1999) Intravertebral vacuum phenomenon following fractures: CT study on frequency and etiology. J Comput Assist Tomogr 23:976–980
Kubota T, Yamada K, Ito H 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 29:712–719
Matin P (1979) The appearance of bone scans following fractures, including immediate and long-term studies. J Nucl Med 20:1227–1231
Bredella MA, Essary B, Torriani M et al (2008) Use of FDG-PET in differentiating benign from malignant compression fractures. Skeletal Radiol 37:405–413
Cho WI, Chang UK (2011) Comparison of MR imaging and FDG-PET/CT in the differential diagnosis of benign and malignant vertebral compression fractures. J Neurosurg Spine 14:177–183
Zhuang H, Sam JW, Chacko TK et al (2003) Rapid normalization of osseous FDG uptake following traumatic or surgical fractures. Eur J Nucl Med Mol Imaging 30:1096–1103
An HS, Andreshak TG, Nguyen C et al (1995) Can we distinguish between benign versus malignant compression fractures of the spine by magnetic resonance imaging? Spine (Phila Pa 1976) 20:1776–1782
Baur A, Stabler A, Bruning R et al (1998) Diffusion-weighted MR imaging of bone marrow: differentiation of benign versus pathologic compression fractures. Radiology 207:349–356
Linn J, Birkenmaier C, Hoffmann RT et al (2009) The intravertebral cleft in acute osteoporotic fractures: fluid in magnetic resonance imaging-vacuum in computed tomography? Spine (Phila Pa 1976) 34(2):E88–E93
Thawait SK, Kim J, Klufas RA et al (2013) Comparison of four prediction models to discriminate benign from malignant vertebral compression fractures according to MRI feature analysis. AJR Am J Roentgenol 200:493–502
Shih TT, Huang KM, Li YW (1999) Solitary vertebral collapse: distinction between benign and malignant causes using MR patterns. J Magn Reson Imaging 9:635–642
Ishiyama M, Fuwa S, Numaguchi Y et al (2010) Pedicle involvement on MR imaging is common in osteoporotic compression fractures. AJNR Am J Neuroradiol 31:668–673
Baur A, Huber A, Ertl-Wagner B 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. AJNR Am J Neuroradiol 22:366–372
Spuentrup E, Buecker A, Adam G et al (2001) Diffusion-weighted MR imaging for differentiation of benign fracture edema and tumor infiltration of the vertebral body. AJR Am J Roentgenol 176:351–358
Chan JH, Peh WC, Tsui EY et al (2002) Acute vertebral body compression fractures: discrimination between benign and malignant causes using apparent diffusion coefficients. Br J Radiol 75:207–214
Zhou XJ, Leeds NE, McKinnon GC et al (2002) Characterization of benign and metastatic vertebral compression fractures with quantitative diffusion MR imaging. AJNR Am J Neuroradiol 23:165–170
Maeda M, Sakuma H, Maier SE et al (2003) Quantitative assessment of diffusion abnormalities in benign and malignant vertebral compression fractures by line scan diffusion-weighted imaging. AJR Am J Roentgenol 181:1203–1209
Tang G, Liu Y, Li W (2007) Optimization of b value in diffusion-weighted MRI for the differential diagnosis of benign and malignant vertebral fractures. Skeletal Radiol 36:1035–1041
Balliu E, Vilanova JC, Peláez I et al (2009) Diagnostic value of apparent diffusion coefficients to differentiate benign from malignant vertebral bone marrow lesions. Eur J Radiol 69:560–566
Geith T, Schmidt G, Biffar A et al (2012) Comparison of qualitative and quantitative evaluation of diffusion-weighted MRI and chemical-shift imaging in the differentiation of benign and malignant vertebral body fractures. AJR Am J Roentgenol 199:1083–1092
Castillo M, Arbelaez A, Smith JK et al (2000) Diffusion-weighted MR imaging offers no advantage over routine noncontrast MR imaging in the detection of vertebral metastases. AJNR Am J Neuroradiol 21:948–953
Finelli DA (2001) Diffusion-weighted imaging of acute vertebral compressions: specific diagnosis of benign versus malignant pathologic fractures. AJNR Am J Neuroradiol 22:241–242
Eito K, Waka S, Naoko N et al (2004) Vertebral neoplastic compression fractures: assessment by dual-phase chemical shift imaging. J Magn Reson Imaging 20:1020–1024
Erly WK, Oh ES, Outwater EK (2006) The utility of in-phase/opposed-phase imaging in differentiating malignancy from acute benign compression fractures of the spine. AJNR Am J Neuroradiol 27:1183–1188
Ragab Y, Emad Y, Gheita T et al (2009) Differentiation of osteoporotic and neoplastic vertebral fractures by chemical shift {in-phase and out-of phase} MR imaging. Eur J Radiol 72:125–133
Yuzawa Y, Ebara S, Kamimura M (2005) Magnetic resonance and computed tomography-based scoring system for the differential diagnosis of vertebral fractures caused by osteoporosis and malignant tumors. J Orthop Sci 10:345–352
Baker LL, Goodman SB, Perkash I et al (1990) Benign versus pathologic compression fractures of vertebral bodies: assessment with conventional spin-echo, chemical-shift, and STIR MR imaging. Radiology 174:495–502
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
Copyright information
© 2015 Springer-Verlag Italia
About this chapter
Cite this chapter
Moulopoulos, L.A., Koutoulidis, V. (2015). Benign Versus Malignant Vertebral Fractures. In: Bone Marrow MRI. Springer, Milano. https://doi.org/10.1007/978-88-470-5316-8_8
Download citation
DOI: https://doi.org/10.1007/978-88-470-5316-8_8
Published:
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-5315-1
Online ISBN: 978-88-470-5316-8
eBook Packages: MedicineMedicine (R0)