The Diagnostic Value of Magnetic Resonance Imaging in Identifying Unsuspected Malignancy in Patients Undergoing Percutaneous Vertebral Augmentation for Vertebral Compression Fractures

Percentage of vertebral compression fractures (VCFs) secondary to malignancy for patients who underwent percutaneous vertebral augmentation procedures (PVAPs). The < 60 years age group had the largest percentage of VCF secondary to malignancy, of 40%, followed by 19.8%, 4.8%, and 2.2% for 60 to 69, 70 to 79, and > 80 years age groups, respectively.

(A) Sagittal T1W; (B) sagittal T1FS + contrast; (C) axial T2W at L1 level; (D) axial T1FS + contrast at L1 level. There is a T1 hypointense lesion demonstrating contrast enhancement involving almost the entire L1 vertebral body in a patient with background breast cancer. Furthermore there is enhancement of the paravertebral soft tissue at this level suspicious for extraosseous component (indicated with an arrow). Note L5 is sacralised.

(A) Sagittal T1W; (B) T1W FS with contrast; (C) axial T2W at T12; (D) axial T1 FS with contrast at T12. MRI thoracic spine of a patient with nonpathological grade 3 compression fracture of T12 vertebra status-post vertebroplasty (low signal indicated by arrow). Compare the relatively normal T1 bone marrow signal and lack of contrast enhancement and spinal canal involvement with prior figure of a patient with spinal metastasis.