Evaluation of fat suppression in contrast-enhanced MR of neoplastic and inflammatory spine disease.

PURPOSE To determine the benefit of fat suppression in conjunction with gadolinium enhancement for evaluating neoplastic and inflammatory diseases of the spine. METHODS Contrast-enhanced T1-weighted images were compared with the corresponding contrast-enhanced T1-weighted images with fat suppression in 14 patients with various neoplastic and inflammatory spine diseases. RESULTS Contrast-enhanced T1-weighted images with fat suppression showed enhancing lesions in all cases of vertebral disease (five cases), but in one case some metastases did not enhance. Paravertebral (nine lesions), epidural (seven lesions), and intradural-extramedullary (six lesions) were delineated better with contrast-enhanced fat suppression. In the 14 cases (29 lesions), nine lesions were seen only on contrast-enhanced images with fat suppression. Integrity of the vertebral end plates was assessed more accurately on fat-suppressed images. CONCLUSION Although noncontrast T1-weighted images are sufficient to screen for vertebral disease, contrast-enhanced images with fat suppression may detect additional lesions. Fat suppression should be used in conjunction with gadolinium for evaluating epidural, paravertebral, and intradural-extramedullary spinal lesions.