Blood perfusion of vertebral lesions evaluated with gadolinium-enhanced dynamic MRI: In comparison with compression fracture and metastasis

Purpose: To investigate blood perfusion of vertebral lesions using dynamic Gd-DTPA-enhanced MRI. Materials and Methods: Dynamic MR studies were performed for cases of acute compression fracture, chronic compression fracture, metastatic vertebral lesions with or without compression fracture. A total of 42 patients (71 vertebral segments) were included. Five types of time-intensity curves TICs) were defined as: nearly no enhancement (type A), slow enhancement (type B), a rapid contrast wash-in followed by an equilibrium phase (type Q, a rapid contrast wash-in followed by early wash-out (type D), and a rapid contrast wash-in with a second slower-rising slope (type E), Results: Metastatic vertebral lesions with or without fracture had a higher peak enhancement percentage and steeper enhancement slope than those of chronic compression fracture, but had no difference as compared to those of acute compression fracture. The type D curve had high positive predictive value for metastatic group (100%), and the type E curve had high positive predictive value for benign compression fracture (85.7%). Conclusion: Type D and E curves are valuable in the differentiation of benign and malignant vertebral lesions.