The aim of this review is to establish the correct diagnosis of malignant and benign compression vertebral fractures by MRI to determine treatment and prognosis.
Over 5 months period all the MRI examination of fractured vertebrae reported by the radiology department at KHMC were reviewed. Data collected for examination include MRI conventional T1W, T2W spin echo sequences and fast spin echo with STIR (short inversion recovery) sequences. All the cases selected were given intravenous gadolinium contrast medium. Evaluation of the compressed vertebrae includes children and adults, males and females of different ages.
Certain criteria are used to differentiate between benign and malignant collapsed vertebrae on MRI based on the signal intensity, morphology and pattern of contrast enhancement for correct diagnosis.
In conclusion, homogenous and diffuse abnormal signal intensity, posterior convexity and involvement of the pedicles are signs that are strongly suggestive of malignant vertebral compression; conversely, a band-like area of low signal intensity adjacent to the depressed endplate or preservation of signal intensity of the vertebra suggests benign nature of the collapse.