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Vertebrae adjacent to spinal bone lesion are inconsistent reference markers: A magnetic resonance spectroscopic viewpoint
Author(s) -
Rumpel Helmut,
Chan Ling Ling,
Chan Lai Peng,
Png Meng Ai,
Tan Raymond K.L.,
Lim Winston E.H.
Publication year - 2006
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.20531
Subject(s) - medicine , magnetic resonance imaging , vertebra , osteoporosis , nuclear medicine , thoracic vertebrae , radiology , voxel , lumbar vertebrae , lesion , anatomy , pathology , lumbar
Purpose To ascertain the suitability of vertebrae adjacent to spinal bone lesions as a signal intensity reference on MRI, and compare the MR spectroscopic appearance of vertebral body compression fractures due to malignant tumor infiltration, bone weakening (e.g., osteoporosis), and/or minor trauma. Materials and Methods Twenty‐five patients with spinal compression fractures underwent routine spinal MRI with an additional 1 H MRS study protocol to assess the percent fat fraction of the compressed vertebrae as well as the adjacent bony environment. Peak areas for water and total lipid were calculated from short‐TE single‐voxel 1 H MR spectra using the LCModel analyzing tool. Results There were consistent water‐only patterns in the fractured vertebra suggesting either near complete marrow replacement by malignant tissue or local edematous fluid/hemorrhage within the marrow spaces. However, the adjacent vertebrae showed a wide range of patterns from a dominant lipid signal to the inverse of a pronounced water level. These results far exceed the normal variation expected based on age and sex. Conclusion The results suggest that the adjacent vertebrae may not be an accurate reference, especially in diffusion‐weighted imaging (DWI), because of the large difference between the two compartments. Furthermore, in the case of gradient‐echo measurements, the in‐phase vs. opposed‐phase effects are significant. J. Magn. Reson. Imaging 2006. © 2006 Wiley‐Liss, Inc.