Magnetic resonance spectroscopy (MRS) of vertebral column – an additional tool for evaluation of aggressiveness of vertebral hemangioma like lesion - a case report

Abstract

ABSTRACT

Background: Most vertebral hemangiomas 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).

Patient and method: We present a patient with large symptomatic aggressive hemangioma like lesion in 12^th thoracic vertebra in which a magnetic resonance spectroscopy (MRS) was used to analyze fat content within the lesion.

Results: The lesion in affected vertabra 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 hemangioma. The diagnosis was confirmed with biopsy, performed during the treatment – percutaneous vertebroplasty.

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

Key words: aggressive vertebral hamangioma, magnetic resonance spectroscopy,                        percutaneous vertebroplasty