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Radiology · Spine imaging: vertebral metastasis
Sample itemA bone scan shows multiple hot spots in the spine. MRI of one vertebra shows loss of the normal T1 marrow signal with sparing of the disc. What does this suggest?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Metastatic marrow infiltration
Normal marrow fat is bright on T1, so replacement by tumour causes a dark T1 signal. The disc is characteristically spared in metastases. Benign osteoporotic fractures retain some fat signal and show a fluid sign.
Option by option
A. Metastatic marrow infiltration (correct)
Correct. Replacement of marrow fat by tumour causes T1 hypointensity.
B. Normal red marrow in a child
A normal child's marrow shows no focal lesion.
C. Osteoporotic wedge fracture only
Osteoporotic fractures preserve fatty marrow in part.
D. Disc infection
Disc infection destroys the disc and endplates.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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