Table 4.

MRI criteria for the differential diagnosis of benign vs. malignant vertebral fractures [41]

	Osteoporotic fractures	Malignant fractures
Marrow signal	Normal on all sequences (old fracture)	Diffusely low on T1-weighted images
	Band like low SI adjacent to fracture (acute)	High or heterogeneous on T2-weighted images
	Normal SI preserved opposite the fractured end plate	Round or irregular foci of marrow replacement
		Posterior elements involved
		Soft tissues/epidural involvement
Contrast enhancement	Homogeneous ‘return to normal’ SI after injection	High or heterogeneous
Vertebral contours	Retropulsion of a posterior bone fragment (often postero-superior)	Convex posterior cortex