J Korean Neurosurg Soc.  2009 Dec;46(6):528-531. 10.3340/jkns.2009.46.6.528.

Enhancing Box Sign : Enhancement Pattern of Acute Osteoprotic Compression Fracture

• Kim CH
• Park JH
• Chung SK
• Kim KJ
• Bang JS
• Kim HJ

• KMID: 2190201
• DOI: http://doi.org/10.3340/jkns.2009.46.6.528

Abstract

OBJECTIVE
Although gadolinium enhancement of compression fractures is well known, the enhancement pattern of the acute stage of a fracture is not completely understood. Here, we investigated the enhancement pattern of acute vertebral compression fractures (VCFs). METHODS: We conducted a retrospective study of patients with acute osteoporotic VCFs admitted to hospital between January 2004 and December 2005. The demographic details, stage of the fracture, management data, and results were analyzed. There were nine men and 22 women, and the mean age was 71 years (range, 53-92 years). According to the onset of pain, patients were divided into the following four groups : Group I (less than 3 days), Group II (4-7 days), Group III (8-14 days), and Group IV (14-30 days). RESULTS: All patients had central low-signal intensity of the nonenhancing part of vertebral bodies on T1 images. Enhancing box sign (EBS) was seen 7 days of VCF development. After 7 days of onset (Groups III and IV), patch or Kummell's enhancements occurred. EBS has been statistically correlated with stage of compression fracture (Pearson's correlation = -0.774). However, EBS had no statistically significant correlation with prognosis in our study (Pearson's correlation = 0.059). CONCLUSION: EBS represents a characteristic sign 7 days of VCF development.

Keyword

Compression fracture; Magnetic resonance imaging; Gadolinium

MeSH Terms

Female
Fractures, Compression
Gadolinium
Humans
Magnetic Resonance Imaging
Male
Prognosis
Retrospective Studies
Gadolinium