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Journal of Korean Neurosurgical Society 2009;46(6): 528-531.
doi: https://doi.org/10.3340/jkns.2009.46.6.528
Enhancing Box Sign : Enhancement Pattern of Acute Osteoprotic Compression Fracture.
Choong Hyo Kim, Jae Hyo Park, Sang Ki Chung, Ki Jeong Kim, Jae Seung Bang, Hyun Jib Kim
1Department of Neurosurgery, Kangwon National University College of Medicine, Chuncheon, Korea.
2Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea. jibkim@snu.ac.kr
3Department of Neurosurgery, East-West Neo Medical Center, Kyung Hee University School of Medicine, Seoul, Korea.
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.
Key Words: Compression fracture; Magnetic resonance imaging; Gadolinium
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