ABSTRACT
<p><b>OBJECTIVE</b>To study MRI changes of vertebral metastasis and their value in differential diagnosis.</p><p><b>METHODS</b>MR films of 103 patients with vertebral metastasis confirmed clinically or pathologically were reviewed with all features recorded and analyzed.</p><p><b>RESULTS</b>338 vertebrae were involved in 103 patients, including 82 in vertebral body only, 3 in appendix only and 253 in both. According to the shape of vertebral body and the characteristic abnormality, 335 vertebrae with body involved were divided into 4 types: Type I (97) with one single focus in the vertebral body, type II (102) with multiple foci with clear margin in the vertebral body, type III (16) with abnormal signal in the whole vertebral body and type IV (120) with abnormal signal in the whole or most part of vertebral body complicated with compression fracture. Among all these lesions, 114 showed concave superior and/or inferior edges and 116 protruding posterior and/or anterior borders. In 256 vertebrae with abnormal appendix, 238 showed abnormal pedicle of vertebral arch involving neighbouring part of vertebral body and 235 showed enlarged pedicle and other parts of the appendix. Soft tissue mass was showed around 133 vertebrae, with the center at the involved vertebrae on sagittal image. 130 pieces of these masses extended cranio-caudally within or a little beyond the width of a vertebral body.</p><p><b>CONCLUSION</b>Vertebral metastasis is characterized by involving multiple vertebrae. Its diagnosis and differential diagnosis can be made definite in most patients according to the lesions distribution, change in vertebral shape and the characteristics of the soft tissue mass.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Diagnosis, Differential , Magnetic Resonance Imaging , Spinal Neoplasms , DiagnosisABSTRACT
Objective To investigate the value of the imaging findings of soft tissue abnormality in the differential diagnosis between osteomyelitis and malignant bone tumor.Methods The CT and MRI findings of soft tissue changes in 57 cases of osteomyelitis and 70 cases of malignant bone tumor were retrospectively defined,observed,recorded and statistically analyzed.Results In 57 cases of osteomyelitis, 54 cases were examined with CT,and soft tissue swelling was presented in 52 cases (degree Ⅰin 19 cases, degreeⅡin 16 cases,degree Ⅲin 17 cases).Abscess-like cysts in soft tissue occurred in 6 cases,masses in 5,air in 1,fat-fluid level in 1 and sinus tract in 1.Among 14 cases examined with MR imaging,soft tissue swelling was presented in all cases (degreeⅠin 2 cases,degree Ⅱin 6 cases and degree Ⅲin 6 cases). Abscess-like cysts appeared in 3 cases and showed high signal in diffusion weighted imaging, mass in Ⅰand fat-fluid level in 1.Among 54 cases examined with CT in 70 cases of malignant bone tumor, soft tissue swelling was presented in 44 cases (degreeⅠin 29 cases,degreeⅡin 12 cases,degreeⅢin 3 cases).Soft tissue masses appeared in 49 cases,bone shell and shell-like calcification in 16 cases and neoplastic bone and neoplastic calcified cartilage within soft tissue mass in 25 cases.Among 49 cases examined with MR imaging,soft tissue swelling was presented in 46 cases (degree Ⅰin 21 cases,degreeⅡin 17 cases and degree Ⅲin 8 cases),and soft tissue masses appeared in 43 cases.The degree of soft tissue swelling and the occurrence of abscess-like cyst,mass,bone shell or shell-liked calcification in the rim of mass,neoplastic bone or neoplastic calcified cartilage in masses showed significant difference(P