MRI features (designation and description) included in Research Synthesis
1. Complete replacement of normal bone marrow: Edema-like signal involving the entire
vertebral body.
2. Band like shape of bone marrow edema: Horizontal strip/band of edema-like signal
subjacent and paralleling the depressed endplate of the vertebral compression fracture not
involving the entire vertebral body.
3. “Fluid sign”: Discrete focal, linear, or triangular area/cleft of fluid-like signal intensity
(without trabeculae coursing through) superimposed on a background of marrow edemalike signal in the vertebral body.
4. Epidural Mass: Extra-osseous soft tissue signal abnormality emanating from the posterior
aspect of the vertebral body occurring in the epidural space.
5. Para-spinal mass: Extra-osseous soft tissue signal abnormality present adjacent to the
anterior/lateral aspects vertebral body as opposed to posterior/epidural aspect.
6. Posterior vertebral border convexity – diffuse: Diffusely/smooth convex contour of the
posterior vertebral border from cranial to caudal and best visualized on sagittal images.
7. Posterior vertebral border convexity – focal: Focally, usually superior, convex contour of
the posterior vertebral border as seen on sagittal images. Also known as retropulsed
fragment sign.
8. Pedicle Involvement: Abnormal bone marrow edema-like signal intensity of the pedicle.
9. Posterior Element Involvement: Abnormal bone marrow edema-like signal intensity of
the posterior elements (lateral masses/lamina/spinous process) beyond the pedicle.
10. Intravertebral Disc Involvement: Abnormal fluid-like signal intensity of discs adjacent to
the compressed endplate of the index VCF.
11. Compression of All Vertebral Columns: Deformity that equally involves the anterior and
posterior aspect of the vertebral endplate such that the vertebra appears compressed but
not wedged.
12. Endplate Integrity: Intact or disrupted low signal line subjacent to the disc and
marginating the vertebral compression fracture representing cortical bone/cartilage
margin.
13. In-phase/Opposed-phase Signal Intensity Ratio (SIR): Computation of the measured
signal intensity of the marrow on the opposed phase to signal intensity measured on the
in-phase images within the area of signal alteration of the index vertebral compression
fracture.
14. Apparent Diffusion Coefficient (ADC) on diffusion weighted images (DWI): ADC
values are calculated from the signal intensities of images acquired with varying
magnitudes of diffusion sensitivity (b-values).
15. Multiple levels of VCF (vertebral compression fractures) with BME (bone marrow
edema): Additional vertebral compression fractures present with bone marrow edemalike signal alteration of the vertebral body.
16. Presence of other non-characteristic bone marrow lesions: Additional bone marrow signal
abnormalities present in other non-index lesion vertebrae without a characteristic pattern,
location or signal.
17. Coexisting benign (healed) VCF (vertebral compression fractures): additional vertebral
compression deformities without edema-like signal in the marrow representing healed
benign fractures.