Vertebral osteonecrosis: MR imaging findings and related changes on adjacent levels
Journal
American Journal of Neuroradiology
Journal Volume
28
Journal Issue
1
Pages
42-47
Date Issued
2007
Author(s)
Abstract
BACKGROUND AND PURPOSE: No prior report has comprehensively discussed the intravertebral vacuum cleft sign and the fluid sign on MR images of vertebral osteonecrosis. The purpose of this study was to investigate MR images of osteonecrotic vertebral bodies and adjacent intervertebral disks and vertebral bodies. METHODS: We retrospectively reviewed MR images of patients with vertebral osteonecrosis. Affected vertebral bodies with osteonecrosis were defined as an avascular area (nonenhanced area on enhanced T1-weighted images) with collections of intravertebral fluid (hyperintense signal on T2-weighted images), air (signal void on all images), or both. The degree of vertebral collapse was classified as mild (>50%) or severe (<50%) preserved vertebral height. Changes in adjacent intervertebral disks or vertebral bodies 2 above and 2 below the affected vertebrae were compared. RESULTS: We enrolled 112 patients (30 men, 82 women; 121 vertebral bodies) in our study. Intravertebral air alone was observed in 48 involved levels (39.7%), intravertebral fluid alone was found in 47 (38.8%), and both coexisted in 26 (21.5%). Degree of vertebral collapse in affected vertebral bodies significantly differed with presence of air or fluid (P < .05). Vertebral compression fractures adjacent to the affected vertebral bodies were more common in those with intravertebral air alone than in those with intravertebral fluid alone (P < .05). CONCLUSION: Vertebral collapse was more advanced and adjacent vertebral compression fractures were more frequent in patients with intravertebral air than in those with intravertebral fluid.
SDGs
Other Subjects
adult; aged; air; bone necrosis; computer assisted diagnosis; computer assisted tomography; contrast enhancement; diagnostic imaging; diagnostic value; diffusion weighted imaging; disease severity; female; human; image analysis; intervertebral disk; liquid; major clinical study; male; nuclear magnetic resonance imaging; review; vertebra body; vertebra osteonecrosis; Aged; Aged, 80 and over; Air; Edema; Female; Fractures, Compression; Fractures, Spontaneous; Humans; Intervertebral Disk; Lumbar Vertebrae; Magnetic Resonance Imaging; Male; Middle Aged; Observer Variation; Osteonecrosis; Retrospective Studies; Sensitivity and Specificity; Spinal Diseases; Spinal Fractures; Thoracic Vertebrae
Type
review