Spinal Hemangioma

Axial and sagittal reformatted CT images show a well circumscribe lytic lesion in the body of the thoracic spine with a "polka-dot" pattern (best appreciated on the axial image).

Facts: Spinal Hemangioma

• Most common benign lesions with a vascular origin
• In the spine, they are usually cavernous or mixed types
• Most common location = thoracolumbar or lumbar spine
• Can be seen in any age but most common after 40 years
• Mostly asymptomatic but can rarely cause compression fracture, spinal cord compression or nerve root encroachment

Imaging Findings

• Well circumscribe lytic lesion
• Internal thickened trabeculae (seen as "polka-dot" on axial view and vertical striation on reformations)
• On MRI, hemangiomas are hyperintense on both T1WI (likely due to fat component) and T2WI, with enhancement

Reference:

Herkowitz HN, Bell GR. The Lumbar Spine, 3rd edition, 2004.