Magnetic resonance imaging of the metastatic vertebral tumor

Fourty two patients underwent MR studies for a variety of lesions in the vertebral body. A 0.15-T MR system was employed. Twenty five patients were found to have malignant metastatic lesions (group 1); 16 had non-neoplastic lesions (group 2). The ability to discriminate between group 1 and group 2 with MR imaging was evaluated. All malignant metastatic lesions appeared as low intensity areas on both T1-weighted spin echo image and inversion recovery image, but 44 to 53% of the non-neoplastic lesions appeared as low intensity areas, respectively. The diagnostic ability with signal intensity of the vertebral column was evaluated on various pulse sequences; sensitivity of inversion recovery and T1-weighted spin echo image was 100%, in contrast specificity of these pulse sequences was 47 to 56%, overall accuracy was the highest on T1-weighted spin echo image (86%). The signal intensity of intervertebral disk was also evaluated in both groups. The intervertebral disks adjacent to the all malignant metastatic lesions showed normal intensity on both T1-weighted spin echo image and inversion recovery image, but non-neoplastic lesions showed variable intensities on images with all pulse sequences. The diagnostic ability with the signal intensities of the vertebral column and intervertebral disk was higher than that of the vertebral columns alone. Consequently accuracy was the highest in that case of both intervertebral disk and bone marrow which were imaged on T1-weighted spin echo (93%). We concluded that this diagnostic method was useful in distinguishing malignant metastatic from non-neoplastic lesions.