Abstract
The MRI characteristics of fractures have been described on the basis of spin echo (SE) images emphasizing T1 and T2 contrast. These previous studies were carried out for injuries in which radiographic proof was often lacking. In comparison with SE images, short tau inversion recovery (STIR) images have been shown to provide superior contrast between normal and abnormal marrow. To determine the MRI characteristics of fracture using STIR pulse sequences, we reviewed 28 patients who had radiographic evidence of fracture and were examined with T1-weighted SE and STIR sequences. MRI marrow signal abnormalities were demonstrated at all fracture sites ranging in age from less than 24 h to 8 weeks. The extent of marrow signal abnormalities exceeded the size of corresponding radiographic findings of fracture in all cases. The MRI features of fractures on T1-weighted SE images consisted of irregular intramedullary zones of hypointensity. On STIR images a corresponding zone of hyperintensity extended to the outer cortical margin. Intramedullary lines of hypointensity extending to the inner cortical margin were identified within the hyperintense marrow abnormality on STIR images in 64% of the fractures. The results of this study show that MRI using T1-weighted SE and STIR sequences can consistently demonstrate prominent signal abnormalities at fracture sites including those in which radiographic signs are subtle.
Similar content being viewed by others
References
Baker LL, Goodman SB, Perkash I, Lane B, Enzmann DR (1990) Benign versus pathologic compression fractures of vertebral bodies: assessment with conventional spin-echo, chemical-shift, and STIR MR imaging. Radiology 174:495
Bydder GM, Young IR (1985) MR imaging: clinical use of the inversion recovery sequence. J Comput Assist Tomogr 9(4):659
Deutsch AL, Mink JH (1989) Magnetic resonance imaging of musculoskeletal injuries. Radiol Clin North Am 27(5):983
Deutsch AL, Mink JH, Waxman AD (1989) Occult fractures of the proximal femur: MR imaging. Radiology 170:113
Dwyer AJ, Frank JA, Sank VJ, Reinig JW, Hickey AM, Doppman JL (1988) Short-TI inversion-recovery pulse sequence: analysis and initial experience in cancer imaging. Radiology 168:827
Greaney RB, Gerber FJ, Laughlin RL, et al. (1983) Distribution and natural history of stress fractures in US Marine recruits. Radiology 146:339
Harned EM, Mitchell DG, Burk DL Jr, Vinitski S, Rifkin MD (1990) Bone marrow findings on magnetic resonance images of the knee: accentuation by fat suppression. Magn Res Imaging 8:27
Holder LE, Schwarz C, Wernicke PG, Michael RH (1990) Radionuclide bone imaging in the early detection of fractures of the proximal femur (hip): multifactorial analysis. Radiology 174:509
Lee JK, Yao L (1988) Stress fractures: MR imaging. Radiology 169:217
Lynch TCP, Crues JV III, Morgan FW, Sheehan WE, Harter LP, Ryu R (1989) Bone abnormalities of the knee: prevalence and significance of MR imaging. Radiology 171:761
Meyers SP, Wiener SN (1991) Diagnosis of hematogenous pyogenic vertebral osteomyelitis by magnetic resonance imaging. Arch Int Med 151:683
Mink JH, Deutsch AL (1989) Occult cartilage and bone injuries of the knee: detection, classification, and assessment with MR imaging. Radiology 170:823
Robbins SL, Cotran RS, Kumar V (1989) Fractures. In: Robbins, Pathologic basis of disease, 4th edn. W.B. Saunders, Philadelphia, p 322
Rogers LF (1982) Fracture healing. In: Radiology of skeletal trauma. Churchill Livingstone, New York, p 105
Shuman WP, Baron RL, Peters MJ, Tazioli PK (1989) Comparison of STIR and spin-echo MR imaging at 1.5T in 90 lesions of the chest, liver, and pelvis. AJR 152:853
Speer KP, Spritzer CE, Harrelson JM, Nunley JA (1990) Magnetic resonance imaging of the femoral head after acute intracapsular fracture of the femoral neck. J Bone Joint Surg [Am] 72:98
Stafford SA, Rosenthal DI, Gebhardt MC, Brady TJ, Scott JA (1986) MRI in stress fracture. AJR 147:553
Stoller DW (1989) Fractures. In: Magnetic resonance imaging in orthopaedics and rheumatology. JB Lippincott, pp 183, 222
Unger E, Moldofsky P, Gatenby R, Hartz W, Broder G (1988) Diagnosis of osteomyelitis by MR imaging. AJR 150:605
Vellet AD, Marks PH, Fowler PJ, Munro TG (1991) Occult posttraumatic osteochondral lesions of the knee: prevalence, classification, and short-term sequelae evaluated with MR imaging. Radiology 178:271
Vogler JB, Murphy WA (1988) Bone marrow imaging. Radiology 168:679
Wiener SN, Neumann DR, Rzeszotarski MS (1989) Comparison of magnetic resonance imaging and radionuclide bone imaging of vertebral fractures. Clin Nucl Med 14:666
Yao L, Lee JK (1988) Occult intraosseous fracture: detection with MR imaging. Radiology 167:749
Yuh WTC, Corson JD, Baraniewski HM, et al. (1989) Osteomyelitis of the foot in diabetic patients: evaluation with plain film, 99m Tc-MDP bone scintigraphy, and imaging. AJR 152:795
Yuh WTC, Zachar CK, Barloon TJ, Sato Y, Sickels WJ, Hawes DR (1989) Vertebral compression fractures: distinction between benign and malignant causes with MR imaging. Radiology 172:215
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Meyers, S.P., Wiener, S.N. Magnetic resonance imaging features of fractures using the short tau inversion recovery (STIR) sequence: correlation with radiographic findings. Skeletal Radiol. 20, 499–507 (1991). https://doi.org/10.1007/BF00194246
Issue Date:
DOI: https://doi.org/10.1007/BF00194246