What are the MRI findings of vertebral hemangiomas?
Nov 06, 2025
Source: Cainiu Health
Dr. Wang Lei
Introduction
MRI findings of vertebral hemangiomas typically include characteristic signal features, well-defined margins, regular morphology, absence of significant bone destruction, and specific enhancement patterns. On T1-weighted images, they usually appear as isointense or hypointense, while on T2-weighted images they show markedly hyperintense signals. Due to abundant slow-flowing blood within the lesion, the signal is generally uniform with sharp borders. Larger lesions may exhibit heterogeneous signals due to calcification.
MRI findings of vertebral hemangiomas generally include typical signal characteristics, clear boundaries, regular shape, absence of obvious bone destruction, and specific enhancement patterns. Detailed analysis is as follows:
1. Typical signal characteristics: On T1-weighted imaging, lesions usually show isointense or hypointense signals, while on T2-weighted imaging they present markedly hyperintense signals. Due to the presence of slow-flowing blood within the lesion, the signal is typically uniform with sharp margins. Larger lesions may show mixed signals due to calcification.
2. Clear boundaries: The lesion has well-defined margins from surrounding normal vertebral bone, without evidence of blurred infiltration. MRI can clearly differentiate the extent of the hemangioma from normal bone tissue and paravertebral soft tissues, providing a basis for localization and diagnosis.
3. Regular morphology: Lesions are mostly round or patchy in shape, distributed along the trabecular spaces of the vertebra. Some may involve the entire vertebral body, and a few may slightly extend to the pedicle or paravertebral area, but without aggressive growth features.
4. No obvious bone destruction: The contour of the vertebral body remains intact, with no signs of bone erosion or structural defects. Signal abnormalities are confined to the lesion area, without causing vertebral collapse or bone fragmentation—features that distinguish it from malignant bone tumors.
5. Specific enhancement pattern: On contrast-enhanced scans, lesions show progressive enhancement—mild peripheral enhancement in the arterial phase, followed by gradual centripetal filling over time. In the delayed phase, the entire lesion demonstrates uniform enhancement, consistent with the enhancement characteristics of vascular lesions.
MRI is an important modality for diagnosing vertebral hemangiomas. A definitive diagnosis can often be made based on typical imaging features combined with clinical context. When presentations are atypical, CT or pathological examination may be needed to rule out other conditions. After confirmation, regular follow-up is recommended to monitor changes in lesion size. If symptoms such as nerve compression occur, timely medical intervention should be carried out according to physician guidance.
