Magnetic resonance imaging of vertebral compression fractures

Magnetic resonance (MR) imaging was performed on 112 patients with 210 vertebral compression fractures. Forty fractures were due to malignancy; 170 were caused by benign process. Pathological fractures showed low signal intensity (SI) on T1 weighted image (WI) and various SI on T2 WI. In 39 of the 40 fractures caused by malignancy, MRI showed complete replacement of normal bone marrow. Other findings of pathological fractures, such as involvement of posterior structures, paraspinal soft tissue masses, are useful for discrimination between benign and pathologic compression fractures. In 120 of the 157 fractures caused osteoporosis had complete preservation of normal bone marrow and isointense or high intense marrow SI on T1 WI and T2 WI. Compression fractures caused by trauma showed low SI on T1 WI and high SI on T2 WI with an irregular pattern. We suppose MRI may be a useful modality in differenciating benign and metastatic fractures. (author)