Veterbal osteoporosis VS metastasis

[Oussama]

Dear Dr,

L4 and L5 vertebral bodies show uniform low signal at T1 and high signal at T2, with edge scalloping, no fracture or collapse or focal lesions are noted.

The remaining vertebrae show minimal scalloping with normal signal intensity.

Is those metastasis or osteoporosis?

Thank u so much in advance.

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
Although I am a radiologist, I will attempt to answer your question the best that I can.
MRI signal intensity on T1 and T2 are quite variable in different disease processes - both benign and malignant. Although sensitive, MRI is not specific in many clinical situations, making the differentiation between benign and malignant disease difficult.
A better test for malignancy would be a nuclear medicine scan - either a bone scan with technitium of F18. A DEXA scan would be useful for establishing or ruling our osteoporosis.
All the best, and God Bless!

[Oussama]

Thanks so much Doctor, it was a helping answer.

Best regards