Book contents
- Frontmatter
- Dedication
- Contents
- Preface
- Case 1 Dense basilar artery sign
- Case 2 Global anoxic brain injury
- Case 3 Acute infarction
- Case 4 Vertebral artery dissection
- Case 5 Subacute infarct
- Case 6 Subarachnoid hemorrhage
- Case 7 Intracranial aneurysms
- Case 8 Giant aneurysms
- Case 9 Acute intracerebral hematoma
- Case 10 Cerebral amyloid angiopathy
- Case 11 Primary CNS vasculitis
- Case 12 Reversible cerebral vasoconstriction syndrome
- Case 13 Moyamoya disease/syndrome
- Case 14 Cortical venous thrombosis
- Case 15 Developmental venous anomalies
- Case 16 Dural arteriovenous fistula
- Case 17 Cavernous malformation
- Case 18 Tumefactive demyelinating lesion
- Case 19 Acute disseminated encephalomyelitis
- Case 20 Progressive multifocal leukoencephalopathy
- Case 21 Osmotic myelinolysis
- Case 22 Neurosarcoidosis
- Case 23 Posterior fossa masses in children
- Case 24 Low-grade glioma
- Case 25 Diffuse intrinsic pontine glioma
- Case 26 Pseudoprogression of GBM
- Case 27 Pseudoresponse in treatment of GBM
- Case 28 Low-grade oligodendroglioma
- Case 29 Primary CNS lymphoma
- Case 30 Pineal region tumors
- Case 31 Intraventricular masses
- Case 32 Colloid cyst
- Case 33 Primary intraosseous meningioma
- Case 34 Suprasellar meningioma
- Case 35 Pituitary macroadenoma
- Case 36 Brain abscess
- Case 37 Neurocysticercosis
- Case 38 Tuberculosis
- Case 39 Creutzfeldt–Jakob disease
- Case 40 Herpes encephalitis
- Case 41 Wernicke’s encephalopathy
- Case 42 Hypertrophic olivary degeneration
- Case 43 Adrenoleukodystrophy
- Case 44 Mild traumatic brain injury
- Case 45 Isodense subdural hematoma
- Case 46 Posterior reversible encephalopathy syndrome
- Case 47 Late-onset adult hydrocephalus secondary to aqueductal stenosis
- Case 48 Intracranial hypotension
- Case 49 Idiopathic intracranial hypertension
- Case 50 Rathke’s cleft cyst
- Case 51 FLAIR sulcal hyperintensity secondary to general anesthesia
- Case 52 Virchow–Robin spaces
- Case 53 Arachnoid granulations
- Case 54 Benign external hydrocephalus
- Case 55 Pitfalls in CTA
- Case 56 Asymmetric pneumatization of the anterior clinoid process
- Case 57 Fibrous dysplasia of skull base
- Case 58 Sphenoid bone pseudolesion
- Case 59 Clival lesions
- Case 60 Perineural spread
- Case 61 Cochlear dysplasia
- Case 62 Labyrinthitis ossificans
- Case 63 Superior semicircular canal dehiscence
- Case 64 Fluid entrapment in the petrous apex cells
- Case 65 Acquired cholesteatoma
- Case 66 Malignant otitis externa
- Case 67 Temporal bone fractures
- Case 68 Allergic fungal sinusitis
- Case 69 Invasive fungal sinusitis
- Case 70 Spontaneous CSF leaks and sphenoid cephaloceles
- Case 71 Juvenile nasal angiofibroma
- Case 72 Idiopathic orbital pseudotumor
- Case 73 Optic neuritis
- Case 74 Intraparotid lymph nodes
- Case 75 Benign mixed tumor
- Case 76 First branchial cleft cyst
- Case 77 Nasopharyngeal cysts
- Case 78 Cystic nodal metastasis
- Case 79 Low-flow vascular malformations
- Case 80 Parapharyngeal masses
- Case 81 Third branchial apparatus anomaly
- Case 82 Parathyroid adenoma
- Case 83 String sign
- Case 84 Carotid artery dissection
- Case 85 Traumatic arterial injury
- Case 86 Craniovertebral junction injuries
- Case 87 Odontoid fractures
- Case 88 Vertebral compression fractures
- Case 89 Sacral insufficiency fracture
- Case 90 Paget’s disease of the spine
- Case 91 Renal osteodystrophy
- Case 92 Calcific tendinitis of the longus colli
- Case 93 T2 hyperintense disc herniation
- Case 94 Disc herniation and cord compression
- Case 95 Postoperative disc herniation versus postsurgical scarring
- Case 96 Degenerative endplate alterations
- Case 97 Spinal dysraphism
- Case 98 Tethered spinal cord
- Case 99 Chiari I malformation
- Case 100 Spinal vascular malformations
- Case 101 Cord compression
- Case 102 Demyelinating/inflammatory spinal cord lesion
- Case 103 Subacute combined degeneration
- Case 104 Intradural cyst
- Case 105 Spinal CSF leaks
- Case 106 Leptomeningeal drop metastases
- Index
- References
Case 88 - Vertebral compression fractures
Published online by Cambridge University Press: 18 December 2013
- Frontmatter
- Dedication
- Contents
- Preface
- Case 1 Dense basilar artery sign
- Case 2 Global anoxic brain injury
- Case 3 Acute infarction
- Case 4 Vertebral artery dissection
- Case 5 Subacute infarct
- Case 6 Subarachnoid hemorrhage
- Case 7 Intracranial aneurysms
- Case 8 Giant aneurysms
- Case 9 Acute intracerebral hematoma
- Case 10 Cerebral amyloid angiopathy
- Case 11 Primary CNS vasculitis
- Case 12 Reversible cerebral vasoconstriction syndrome
- Case 13 Moyamoya disease/syndrome
- Case 14 Cortical venous thrombosis
- Case 15 Developmental venous anomalies
- Case 16 Dural arteriovenous fistula
- Case 17 Cavernous malformation
- Case 18 Tumefactive demyelinating lesion
- Case 19 Acute disseminated encephalomyelitis
- Case 20 Progressive multifocal leukoencephalopathy
- Case 21 Osmotic myelinolysis
- Case 22 Neurosarcoidosis
- Case 23 Posterior fossa masses in children
- Case 24 Low-grade glioma
- Case 25 Diffuse intrinsic pontine glioma
- Case 26 Pseudoprogression of GBM
- Case 27 Pseudoresponse in treatment of GBM
- Case 28 Low-grade oligodendroglioma
- Case 29 Primary CNS lymphoma
- Case 30 Pineal region tumors
- Case 31 Intraventricular masses
- Case 32 Colloid cyst
- Case 33 Primary intraosseous meningioma
- Case 34 Suprasellar meningioma
- Case 35 Pituitary macroadenoma
- Case 36 Brain abscess
- Case 37 Neurocysticercosis
- Case 38 Tuberculosis
- Case 39 Creutzfeldt–Jakob disease
- Case 40 Herpes encephalitis
- Case 41 Wernicke’s encephalopathy
- Case 42 Hypertrophic olivary degeneration
- Case 43 Adrenoleukodystrophy
- Case 44 Mild traumatic brain injury
- Case 45 Isodense subdural hematoma
- Case 46 Posterior reversible encephalopathy syndrome
- Case 47 Late-onset adult hydrocephalus secondary to aqueductal stenosis
- Case 48 Intracranial hypotension
- Case 49 Idiopathic intracranial hypertension
- Case 50 Rathke’s cleft cyst
- Case 51 FLAIR sulcal hyperintensity secondary to general anesthesia
- Case 52 Virchow–Robin spaces
- Case 53 Arachnoid granulations
- Case 54 Benign external hydrocephalus
- Case 55 Pitfalls in CTA
- Case 56 Asymmetric pneumatization of the anterior clinoid process
- Case 57 Fibrous dysplasia of skull base
- Case 58 Sphenoid bone pseudolesion
- Case 59 Clival lesions
- Case 60 Perineural spread
- Case 61 Cochlear dysplasia
- Case 62 Labyrinthitis ossificans
- Case 63 Superior semicircular canal dehiscence
- Case 64 Fluid entrapment in the petrous apex cells
- Case 65 Acquired cholesteatoma
- Case 66 Malignant otitis externa
- Case 67 Temporal bone fractures
- Case 68 Allergic fungal sinusitis
- Case 69 Invasive fungal sinusitis
- Case 70 Spontaneous CSF leaks and sphenoid cephaloceles
- Case 71 Juvenile nasal angiofibroma
- Case 72 Idiopathic orbital pseudotumor
- Case 73 Optic neuritis
- Case 74 Intraparotid lymph nodes
- Case 75 Benign mixed tumor
- Case 76 First branchial cleft cyst
- Case 77 Nasopharyngeal cysts
- Case 78 Cystic nodal metastasis
- Case 79 Low-flow vascular malformations
- Case 80 Parapharyngeal masses
- Case 81 Third branchial apparatus anomaly
- Case 82 Parathyroid adenoma
- Case 83 String sign
- Case 84 Carotid artery dissection
- Case 85 Traumatic arterial injury
- Case 86 Craniovertebral junction injuries
- Case 87 Odontoid fractures
- Case 88 Vertebral compression fractures
- Case 89 Sacral insufficiency fracture
- Case 90 Paget’s disease of the spine
- Case 91 Renal osteodystrophy
- Case 92 Calcific tendinitis of the longus colli
- Case 93 T2 hyperintense disc herniation
- Case 94 Disc herniation and cord compression
- Case 95 Postoperative disc herniation versus postsurgical scarring
- Case 96 Degenerative endplate alterations
- Case 97 Spinal dysraphism
- Case 98 Tethered spinal cord
- Case 99 Chiari I malformation
- Case 100 Spinal vascular malformations
- Case 101 Cord compression
- Case 102 Demyelinating/inflammatory spinal cord lesion
- Case 103 Subacute combined degeneration
- Case 104 Intradural cyst
- Case 105 Spinal CSF leaks
- Case 106 Leptomeningeal drop metastases
- Index
- References
Summary
Imaging description
Non-traumatic vertebral compression fractures (VCF) are common and often secondary to either osteoporosis or metastasis. Radiologists should try to determine the benign or malignant nature of the fracture each time they diagnose a VCF, as this has obvious implications for treatment and prognosis. MRI has the greatest accuracy among imaging modalities in this regard. Bone SPECT scan and FDG-PET are very sensitive but their specificity is markedly limited [1,2].
There are various signal changes, morphologic features and quantitative measurements that can help differentiate benign and malignant VCF [3]. Perhaps the most important signal characteristic is the T1 signal within the fractured vertebra: replacement of marrow fat by metastasis is almost always complete, whereas in osteoporotic VCF there are often areas of preserved marrow signal (Fig. 88.1). Identification of normal marrow signal on T1-weighted images, even in a small portion of the vertebral body, is a good indicator of a benign fracture. Abnormal marrow signal in the pedicles of vertebral bodies can be seen in both malignant and benign fractures, but abnormal signal within the posterior elements is more specific for malignant fracture. Linearly oriented band-like signal changes on either T1- or T2-weighted images favor benign fractures, as does fluid signal within the vertebral body (Fig. 88.1). The posterior border of the vertebral body provides important clues as to the nature of the fracture: a rounded bulge of the posterior border is suggestive of malignant fracture, whereas a triangular bulge is more consistent with benign fracture (Figs. 88.1, 88.2). Presence of paraspinal and/or epidural masses suggests metastasis, although benign fractures may have considerable hematoma when they are acute, which mimics soft tissue mass.
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- Chapter
- Information
- Pearls and Pitfalls in Head and Neck and NeuroimagingVariants and Other Difficult Diagnoses, pp. 398 - 400Publisher: Cambridge University PressPrint publication year: 2013