Magnetic Resonance Spectroscopy (MRS) of Vertebral Column - an Additional Tool for Evaluation of Aggressiveness of Vertebral Haemangioma Like Lesion

Overview

Journal Radiol Oncol

Publisher Sciendo

Specialties Oncology
Radiology

Date 2014 Jul 4

PMID 24991203

Authors

Miran Jeromel

Janez Podobnik

Affiliations

Soon will be listed here.

Abstract

Background: Most vertebral haemangioma are asymptomatic and discovered incidentally. Sometimes the symptomatic lesions present with radiological signs of aggressiveness and their appearance resemble other aggressive lesions (e.g. solitary plasmacytoma).

Case Report: We present a patient with large symptomatic aggressive haemangioma like lesion in 12(th) thoracic vertebra in which a magnetic resonance spectroscopy (MRS) was used to analyse fat content within the lesion. The lesion in affected vertebrae showed low fat content with 33% of fat fraction (%FF). The fat content in non-affected (1(st) lumbar) vertebra was as expected for patient's age (68%). Based on MRS data, the lesion was characterized as an aggressive haemangioma. The diagnosis was confirmed with biopsy, performed during the treatment - percutaneous vertebroplasty.

Conclusions: The presented case shows that MRS can be used as an additional tool for evaluation of aggressiveness of vertebral haemangioma like lesions.

References

Kugel H, Jung C, Schulte O, Heindel W . Age- and sex-specific differences in the 1H-spectrum of vertebral bone marrow. J Magn Reson Imaging. 2001; 13(2):263-8. DOI: 10.1002/1522-2586(200102)13:2<263::aid-jmri1038>3.0.co;2-m. View

Xu J, Shen J, Ding Y, Shen H, Zeng Z, Ma R . The clinical value of combined use of MR imaging and multi-slice spiral CT in limb salvage surgery for orthopaedic oncology patients: initial experience in nine patients. Radiol Oncol. 2012; 46(3):189-97. PMC: 3472943. DOI: 10.2478/v10019-012-0020-4. View

Fox M, Onofrio B . The natural history and management of symptomatic and asymptomatic vertebral hemangiomas. J Neurosurg. 1993; 78(1):36-45. DOI: 10.3171/jns.1993.78.1.0036. View

Schellinger D, Lin C, Hatipoglu H, Fertikh D . Potential value of vertebral proton MR spectroscopy in determining bone weakness. AJNR Am J Neuroradiol. 2001; 22(8):1620-7. PMC: 7974571. View

Cheung N, Doorenbosch X, Christie J . Rapid onset aggressive vertebral haemangioma. Childs Nerv Syst. 2011; 27(3):469-72. DOI: 10.1007/s00381-011-1391-3. View

Chen H, Heuer G, Zaghloul K, Simon S, Weigele J, Grady M . Lumbar vertebral hemangioma presenting with the acute onset of neurological symptoms. Case report. J Neurosurg Spine. 2007; 7(1):80-5. DOI: 10.3171/SPI-07/07/080. View

Deramond H, Depriester C, GALIBERT P, Le Gars D . Percutaneous vertebroplasty with polymethylmethacrylate. Technique, indications, and results. Radiol Clin North Am. 1998; 36(3):533-46. DOI: 10.1016/s0033-8389(05)70042-7. View

Layer G, Traber F, Block W, Braucker G, Kretzer S, Flacke S . [1H MR spectroscopy of the lumbar spine in diffuse osteopenia due to plasmacytoma or osteoporosis]. Rofo. 1999; 169(6):596-600. DOI: 10.1055/s-2007-1015347. View

Baudrez V, Galant C, Vande Berg B . Benign vertebral hemangioma: MR-histological correlation. Skeletal Radiol. 2001; 30(8):442-6. DOI: 10.1007/s002560100390. View

10.

Schick F, Bongers H, Jung W, Skalej M, Lutz O, Claussen C . Volume-selective proton MRS in vertebral bodies. Magn Reson Med. 1992; 26(2):207-17. DOI: 10.1002/mrm.1910260203. View

11.

Schick F, Forster J, Einsele H, Weiss B, Lutz O, Claussen C . Magnetization transfer in hemopoietic bone marrow examined by localized proton spectroscopy. Magn Reson Med. 1995; 34(6):792-802. DOI: 10.1002/mrm.1910340604. View

12.

Bloomer C, Ackerman A, Bhatia R . Imaging for spine tumors and new applications. Top Magn Reson Imaging. 2007; 17(2):69-87. DOI: 10.1097/RMR.0b013e31802bb38f. View

13.

Schellinger D, Lin C, Fertikh D, Lee J, Lauerman W, Henderson F . Normal lumbar vertebrae: anatomic, age, and sex variance in subjects at proton MR spectroscopy--initial experience. Radiology. 2000; 215(3):910-6. DOI: 10.1148/radiology.215.3.r00jn42910. View

14.

Schrock W, Wetzel R, Tanner S, Khan M . Aggressive hemangioma of the thoracic spine. J Radiol Case Rep. 2012; 5(10):7-13. PMC: 3303463. DOI: 10.3941/jrcr.v5i10.828. View

15.

Laredo J, Assouline E, Gelbert F, Wybier M, Merland J, Tubiana J . Vertebral hemangiomas: fat content as a sign of aggressiveness. Radiology. 1990; 177(2):467-72. DOI: 10.1148/radiology.177.2.2217787. View

16.

Pavlisa G, Pavlisa G, Rados M . Diffusion differences between pilocytic astrocytomas and grade II ependymomas. Radiol Oncol. 2012; 45(2):97-101. PMC: 3423727. DOI: 10.2478/v10019-011-0011-x. View

17.

Rodallec M, Feydy A, Larousserie F, Anract P, Campagna R, Babinet A . Diagnostic imaging of solitary tumors of the spine: what to do and say. Radiographics. 2008; 28(4):1019-41. DOI: 10.1148/rg.284075156. View

18.

Laredo J, Reizine D, Bard M, Merland J . Vertebral hemangiomas: radiologic evaluation. Radiology. 1986; 161(1):183-9. DOI: 10.1148/radiology.161.1.3763864. View