Document Detail


The intravertebral cleft in acute osteoporotic fractures: fluid in magnetic resonance imaging-vacuum in computed tomography?
MedLine Citation:
PMID:  19139659     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: The study consisted of a retrospective and a prospective study part. OBJECTIVE: We aimed to investigate the nature of the intravertebral vacuum clefts (IVC) in computed tomography (CT) in acute osteoporotic vertebral fractures in correlation with magnetic resonance imaging (MRI). SUMMARY OF BACKGROUND DATA: IVC and intravertebral fluid accumulations have been shown to be indicative of benign vertebral fractures in CT and MRI, respectively. METHODS: Twenty-eight patients (30 osteoporotic fractures) associated with intravertebral vacuum in CT in whom MRI of the spine was performed were retrospectively analyzed. Moreover, we prospectively performed MRI examinations in 12 consecutive patients with 13 osteoporotic fractures with an intravertebral vacuum in CT. T1-w SE, STIR, and 5 repetitive T2-w TSE studies were performed (1.5 Tesla system, Siemens). Two experienced readers assessed the examinations in consensus with regard to the occurrence and location of the intravertebral and intradiscal vacuum on CT and the corresponding signal alterations in MRI. RESULTS: Twenty-seven (90%) of the retrospectively analyzed fractures with intravertebral vacuum in CT showed a fluid like signal in the location of the vacuum in MRI. In the prospective group, a small fluid-like signal was initially present on T2-weighted sequences in 11 of 13 fractures (84.6%). During the repeated T2-weighted measurements, the fluid occurred or increased markedly in all cases. An intradiscal fluid was present either initially and/or during the course of the examination in 46% of the prospective cases and in 50% of the retrospectively evaluated fractures. CONCLUSION: The occurrence of the fluid in MRI within intravertebral clefts is a dynamic process, which is dependent on the position of the patient and is presumably secondary to the extension momentum in the supine position. This may be due to the negative pressure in the horizontal position in which the fracture site is distracted. intravertebral.
Authors:
Jennifer Linn; Christof Birkenmaier; Ralf T Hoffmann; Maximilian Reiser; Andrea Baur-Melnyk
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Spine     Volume:  34     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-13     Completed Date:  2009-04-09     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E88-93     Citation Subset:  IM    
Affiliation:
Department of Neuroradiology, University Hospital Munich, Munich, Germany. linn@nrad.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Bone Marrow / pathology,  physiopathology,  radiography
Edema / pathology,  physiopathology,  radiography
Female
Gases / metabolism
Humans
Intracellular Fluid / metabolism
Magnetic Resonance Imaging
Male
Middle Aged
Osteonecrosis / pathology,  physiopathology,  radiography
Osteoporosis / pathology*,  physiopathology*,  radiography
Predictive Value of Tests
Prospective Studies
Retrospective Studies
Spinal Fractures / pathology*,  physiopathology*,  radiography
Spine / pathology*,  physiopathology*,  radiography
Tomography, X-Ray Computed
Vacuum
Chemical
Reg. No./Substance:
0/Gases

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