Devoted to diagnostic and interventional spine imaging and therapeutics


1H-MR Spectroscopy in the evaluation of osteoporotic and neoplastic vertebral fractures prior percutaneous vertebroplasty 2012

Interventional Spine

Francesco, Massari, M.D./P.h.D.
Salvatore, A, Masala, Prof., Non ASSR Member
Giovanni, Simonetti, Prof., Non ASSR Member



The detection of spongious vertebral molecular variations can be utilized to distinguish the different sources of bone pathology.The relative water intensity correlates with hematopoietic elements dominating in youth. Instead fat cells proportion increases with age resulting in a conversion of red/yellow marrow.

Methods & Materials

The study was performed with a 3T Magnetic Resonance; we used a single voxel (SV) method (TR/TE 2000/40 msec) with point-resolved spectroscopy sequence (PRESS).We measured % FF and Lipid/Water ratio (LWR) in 63 subjects with MR findings of vertebral fractures related to osteoporosis, multiple myeloma and metastasis. The control group consisted of 65 subjects with no spinal pathologies.


In accordance with the relative presence of fat and water within the vertebral body, we found that in osteoporotic vertebral fracture and in hematopoietic diseases an invertion of physiological LWR is present. This is probably due to intraspongious edema and malignant cells infiltration with replacement of lipid- containing cells.


1H MRS provides a fine evaluation of vertebral bone marrow changes due to primary or secondary pathologies and allows appreciated differences not easily assessable with conventional imaging. In the upcoming future, MR Spectroscopy may be powerful in identifying physiological as well as pathological biochemical changes in vertebral bone. This evaluation will be useful in pre-vertebroplasty planning in order to evaluate vertebrae must be treated.

References/Financial Disclosures

Mathis JM, Deramond H, Belkoff SM (2006) Standards for the performance of percutaneous vertebroplasty: American College of Radiology and Society of Interventional Radiology Guidelines. In: Percutaneous vertebroplasty and kyphoplasty, 2nd edn. Springer Dooms GC, Fisher MR, Hricak H et al (1985) Bone marrow imaging: magnetic resonance studies related to age and sex. Radiology 155:429-432