Background: Most vertebral haemangioma are asymptomatic and discovered incidentally. Sometimes the symptomatic lesions present with radiological signs of aggressiveness and their appearance resemble other aggressive lesions (e.g. solitary plasmacytoma).
Case report: We present a patient with large symptomatic aggressive haemangioma like lesion in 12(th) thoracic vertebra in which a magnetic resonance spectroscopy (MRS) was used to analyse fat content within the lesion. The lesion in affected vertebrae showed low fat content with 33% of fat fraction (%FF). The fat content in non-affected (1(st) lumbar) vertebra was as expected for patient's age (68%). Based on MRS data, the lesion was characterized as an aggressive haemangioma. The diagnosis was confirmed with biopsy, performed during the treatment - percutaneous vertebroplasty.
Conclusions: The presented case shows that MRS can be used as an additional tool for evaluation of aggressiveness of vertebral haemangioma like lesions.
Keywords: aggressive vertebral haemangioma; magnetic resonance spectroscopy; percutaneous vertebroplasty.