MR appearance at different ages of osteoporotic compression fractures of the vertebrae

The purpose of this article is to elucidate the MR appearance at different ages of osteoporotic vertebral compression fractures. We retrospectively analyzed sequential MR studies of 107 vertebrae in 75 patients with osteoporotic compression fractures. Vertebral deformities comprised 35 anteriorly wedged vertebrae, 65 fish vertebrae, four flat vertebrae, and others. Signal alterations were depicted as geographic areas of low intensity on T1-weighted images (T1-WI) and high intensity on T2-WI, or linear areas of low intensity on T1-WI and high or low intensity on T2-WI. In the acute stage, geographic alteration predominated. During a three-month period following the injuries, the extent of the geographic areas increased in 40% of cases on T1-WI. Geographic alteration declined in the chronic stage, whereas the prevalence of linear signals increased. Restoration of fatty marrow was preceded by linear signals without geographic signals on T1-WI (36%). The anteriorly wedged vertebrae collapsed faster than the fish vertebrae. The acute or subacute stage of compression fractures is characterized by a larger alteration of the geographic signal, whereas the chronic stage was evidenced by a smaller area of alteration of the geographic and linear signals or by restoration of fatty marrow. (author)