Fig 5.

A 46-year-old man with upper back pain due to an aggressive T3 hemangioma. A, Axial contrast-enhanced CT scan demonstrates an aggressive T3 hemangioma with intraosseous and extraosseous components. B, Axial prone intraprocedural CT scan during a venogram performed via an 18-gauge needle in the left pedicle/vertebral body. Note extensive vascularity in the vertebral body and in the soft tissues surrounding the vertebral body, including the epidural space. C, Sagittal maximum-intensity-projection CT of a T3 venogram before alcohol ablation demonstrates a vascular lesion with epidural flow. Ethanol ablation was followed by vertebral augmentation for stabilization of the vertebral body. D, Post-alcohol ablation and vertebral augmentation CT demonstrates cement filling the vertebral body and the hyperattenuating ablated extraosseous component posterior to the vertebral body (white arrow).