“The fastest way to separate hemangioma from acute fracture.”
https://youtube.com/shorts/mwDwjmVaJuU
1️⃣ Spinal Hemangioma – MRI Findings
• Location
- Most commonly in the thoracic vertebral body.
• Signal Characteristics
- T1-weighted: High signal (fat-rich).
- T2-weighted: High signal (vascular + fat).
- Fat-suppressed sequences: Decreased signal.
- Post-contrast: Mild to moderate enhancement.
• Morphologic Signs
- Polka-dot sign (axial): Thickened vertical trabeculae.
- Corduroy sign (sagittal): Parallel striated appearance.
- Usually no cortical breach or epidural extension.
• Impression
- Typical benign vertebral hemangioma.
2️⃣ Acute Compression Fracture – MRI Findings
• Signal Characteristics
- T1-weighted: Low signal (acute marrow edema).
- T2 / STIR: High signal (edema).
- Fat-suppressed sequences: Bright high signal.
• Morphology
- Anterior wedge deformity or body height loss.
- Cortical break or endplate irregularity.
- Possible mild retropulsion of the posterior wall.
• Associated Findings
- Paravertebral soft-tissue edema.
- Disc typically intact, no epidural mass.
• Impression
- MRI consistent with acute compression fracture.
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