What causes Mini Brain Appearance in the spine on MRI?
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Answer:
Expansile lytic lesion of a vertebral body due to solitary plasmacytoma, a localized proliferation of neoplastic plasma cells that may progress to multiple myeloma. The lesion shows low to isointense signal on T1-weighted images, iso- to hyperintense on T2-weighted images, with curvilinear low-signal-intensity trabecular struts resembling brain sulci and gyri on axial images (the Mini Brain Appearance).
Why is it called so?
The name Mini Brain Appearance derives from the resemblance of thickened curvilinear trabecular struts and remaining bony architecture within the expansile lesion to the sulci and gyri of a miniature brain on axial MRI.
Pathophysiology
Neoplastic plasma cell infiltration causes osteolysis with destruction of normal trabeculae, leading to reactive thickening and hypertrophy of residual bony trabeculae and cortical struts that form a characteristic curvilinear pattern mimicking cerebral cortical folding.
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