Thoracolumbar MRI
Musculoskeletal system
Case TypeClinical Cases
AuthorsB. Taouli, E. Dion, P.A. Grenier
Patient38 years, female
On CT examination multiple thoracic and lumbar vertebral lytic- and sclerotic-appearing lesions were seen. On MRI multiple cervical and thoracolumbar lesions were sdemonstrated (hypointense on T1-weighted images and slightly hyperintense on T2-weighted images) with surrounding bright signal (probably corresponding to oedema) visible around some lesions. No vertebral fracture was visible, and no disk involvement. The epidural space and soft tissues were spared.
Helical chest CT showed mediastinal and bilateral lymph nodes enlargement, thickening of the peribronchovascular bundles, and parenchymal nodules in a peribronchovascular distribution.
Vertebral lesions usually appear as lytic lesions with sclerotic margins involving the vertebral body and the pedicles (hypointense on T1-weighted images, hyperintense on T2-weighted images). The disk is almost never involved (except in one case report, Kenney et al.). As in our case, a vertebral biopsy is necessary to exclude alternative diagnoses, such as tuberculosis, before initiating steroid therapy. Chest CT is useful to look for associated lymph nodes and parenchymal involvement.
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URL: | https://www.eurorad.org/case/1555 |
DOI: | 10.1594/EURORAD/CASE.1555 |
ISSN: | 1563-4086 |