Aggressive vertebral hemangioma with compressive myelopathy

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Three months history of progressive weakness of the lower limbs

Patient Data

Age: 20 years
Gender: Male
This study is a stack
Sagittal
T1
This study is a stack
Sagittal
T2
This study is a stack
Sagittal
STIR
This study is a stack
Axial
T2
This study is a stack
Sagittal T1
C+ fat sat
This study is a stack
Axial T1
C+ fat sat
Download
Info

The vertebral body, as well as the posterior elements of T6, show an abnormal signal intensity of the bone marrow which appears hypointense on T1WI, hyperintense on T2WI with vertical striations of low signal on both TWI and T2WI within a background of high signal corresponding to a "corduroy sign" on sagittal T1WI and T2WI and "polka-dot sign" on same axial sequences. The post-contrast sequences show an intense and heterogeneous enhancement. 

There is an associated posterior epidural lentiform shaped mass of low signal intensity on T1WI, high signal with intense and relatively homogeneous enhancement on post-contrast sequences. The adjacent segment of the spinal cord is compressed and displaced anteriorly with intramedullary T2 hyperintensity from T5 to T7 level, indicating a compressive myelopathy.

Case Discussion

MRI features highly suggestive of an aggressive vertebral hemangioma with compressive myelopathy

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

:

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.