Detection of vertebral hemangiomas by CT and plain films has been limited to those relatively large lesions that demonstrate a coarse, vertically striated trabecular pattern. On short TR/TE MR sequences, the trabeculae maintain a low-signal intensity, but the high-signal of the intervening matrix usually predominates and tends to obscure the bony trabeculae. Pathologic and chemical shift studies have shown that the matrix of a hemangioma is composed mostly of adipose tissue. On long TR/TE sequences, high-signal in the hemangioma is also seen, due to the presence of angiomatous tissue. Contrary to their appearance in the vertebral body, extraosseous components of hemangiomas have an intermediate T1 and a relatively long T2. The longer T1 is explained by the absence of fat in the extraosseous component. Endnote In many otherwise normal spines, small hyperintense foci are found in the vertebral body marrow on short TR/TE sequences. Postmortem studies of these foci have revealed small hemangiomas or intraosseous islands of fat. Distinction between fat islands and hemangiomas should be possible on T2 images, because the hemangioma maintains the high-signal but the fat becomes progressively lower in signal on longer TE sequences.  

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