Differentiation of malignant @entity891 from XXXX and other benign causes using magnetic resonance imaging.

@entity1 @entity3604 @entity189 @entity1582 @entity891 @entity281 @entity236
INTRODUCTION: Elderly @entity1 presenting with backache and @entity891 are a diagnostic challenge. Plain X-rays, computed tomography and radionuclide bone scans have not always reliably distinguished between benign and malignant causes. Magnetic resonance imaging (MRI) may be able to do so. MATERIALS AND METHODS: @entity1 who underwent MRI evaluation for @entity891 were retrospectively studied. Over a 21-month period from January 1995 to September 1996, 47 @entity1 with 58 vertebral collapses were studied. Benign and malignant aetiologies were established by serial imaging, clinical outcome and histology. Imaging was performed with T1 and T2-weighted sequences, with contrast enhancement in some @entity1 . Collapsed vertebrae were examined for appearance of marrow on T1 and T2-weighted sequences and after contrast administration, signal intensity of adjacent discs, degree of @entity236 , involvement of posterior elements, presence or absence of paraspinal mass and end-plate integrity. Agreement between the final and radiological diagnosis was evaluated. RESULTS: There were 36 benign vertebral collapses (20 @entity3604 , 7 post-traumatic, 9 infective) and 22 malignant ones (20 metastatic @entity189 , 2 multiple @entity1582 ). Features which pointed to malignant cause were hypointense marrow on T1-weighted images, marrow enhancement after intravenous contrast, greater than 50% @entity236 and involvement of posterior elements. Of the vertebral collapses due to @entity281 , 78% showed end-plate disruption. CONCLUSIONS: This study shows that MRI can be used to accurately differentiate between benign and malignant causes of @entity891 . Further differentiation between an @entity3604 , traumatic or infective cause can be done with the help of clinical history and evaluation of end-plate integrity.
