Common benign venous malformation within vertebrae
Usually intraosseous, may have epidural component
Rare: Purely epidural spinal hemangioma
Typically, incidental lesion identified on imaging performed for unrelated reasons
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Angiographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Parekh AD et al: Long-term tumor control with radiotherapy for symptomatic hemangioma of a vertebral body. Spine (Phila Pa 1976). 44(12):E731-4, 2019
Peckham ME et al: Imaging of vascular disorders of the spine. Radiol Clin North Am. 57(2):307-18, 2019
Wang B et al: Atypical radiographic features of aggressive vertebral hemangiomas. J Bone Joint Surg Am. 101(11):979-86, 2019
Acosta FL Jr et al: Treatment of Enneking stage 3 aggressive vertebral hemangiomas with intralesional spondylectomy: report of 10 cases and review of the literature. J Spinal Disord Tech. 24(4):268-75, 2011
Ropper AE et al: Primary vertebral tumors: a review of epidemiologic, histological, and imaging findings, Part I: benign tumors. Neurosurgery. 69(6):1171-80, 2011
Singh P et al: Treatment of vertebral hemangiomas with absolute alcohol (ethanol) embolization, cord decompression, and single level instrumentation: a pilot study. Neurosurgery. 68(1):78-84; discussion 84, 2011
Alexander J et al: Vertebral hemangioma: an important differential in the evaluation of locally aggressive spinal lesions. Spine (Phila Pa 1976). 35(18):E917-20, 2010
Hurley MC et al: Preoperative Onyx embolization of aggressive vertebral hemangiomas. AJNR Am J Neuroradiol. 29(6):1095-7, 2008
Bandiera S et al: Symptomatic vertebral hemangioma: the treatment of 23 cases and a review of the literature. Chir Organi Mov. 87(1): 1-15, 2002
Gabal AM: Percutaneous technique for sclerotherapy of vertebral hemangioma compressing spinal cord. Cardiovasc Intervent Radiol. 25(6): 494-500, 2002
Murugan L et al: Management of symptomatic vertebral hemangiomas: review of 13 patients. Neurol India. 50(3): 300-5, 2002
Bas T et al: Efficacy and safety of ethanol injections in 18 cases of vertebral hemangioma: a mean follow-up of 2 years. Spine. 26(14): 1577-82, 2001
Baudrez V et al: Benign vertebral hemangioma: MR-histological correlation. Skeletal Radiol. 30(8): 442-6, 2001
Miszczyk L et al: The efficacy of radiotherapy for vertebral hemangiomas. Neoplasma. 48(1):82-4, 2001
Cross JJ et al: Imaging of compressive vertebral haemangiomas. Eur Radiol. 10(6):997-1002, 2000
Doppman JL et al: Symptomatic vertebral hemangiomas: treatment by means of direct intralesional injection of ethanol. Radiology. 214(2): 341-8, 2000
Lee S et al: Extraosseous extension of vertebral hemangioma, a rare cause of spinal cord compression. Spine. 24(20): 2111-4, 1999
Pastushyn AI et al: Vertebral hemangiomas: diagnosis, management, natural history and clinicopathological correlates in 86 patients. Surg Neurol. 50(6): 535-47, 1998
Griffith JF et al: Clinics in diagnostic imaging (25). Aggressive vertebral haemangioma. Singapore Med J. 38(5): 226-30, 1997
Jayakumar PN et al: Symptomatic vertebral haemangioma: endovascular treatment of 12 patients. Spinal Cord. 35(9): 624-8, 1997
Sakata K et al: Radiotherapy of vertebral hemangiomas. Acta Oncol. 36(7):719-24, 1997
Ide C et al: Vertebral haemangiomas with spinal cord compression: the place of preoperative percutaneous vertebroplasty with methyl methacrylate. Neuroradiology. 38(6): 585-9, 1996
Guedea F et al: The role of radiation therapy in vertebral hemangiomas without neurological signs. Int Orthop. 18(2): 77-9, 1994
Fox MW et al: The natural history and management of symptomatic and asymptomatic vertebral hemangiomas. J Neurosurg. 78(1): 36-45, 1993
Laredo JD et al: Vertebral hemangiomas: fat content as a sign of aggressiveness. Radiology. 177(2):467-72, 1990
Nguyen JP et al: Vertebral hemangiomas presenting with neurologic symptoms. Surg Neurol. 27(4):391-7, 1987
Nicola N et al: Vertebral hemangioma: retrograde embolization-stabilization with methyl methacrylate. Surg Neurol. 27(5):481-6, 1987
Ross JS et al: Vertebral hemangiomas: MR imaging. Radiology. 165(1):165-9, 1987
Common benign venous malformation within vertebrae
Usually intraosseous, may have epidural component
Rare: Purely epidural spinal hemangioma
Typically, incidental lesion identified on imaging performed for unrelated reasons
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Angiographic Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Parekh AD et al: Long-term tumor control with radiotherapy for symptomatic hemangioma of a vertebral body. Spine (Phila Pa 1976). 44(12):E731-4, 2019
Peckham ME et al: Imaging of vascular disorders of the spine. Radiol Clin North Am. 57(2):307-18, 2019
Wang B et al: Atypical radiographic features of aggressive vertebral hemangiomas. J Bone Joint Surg Am. 101(11):979-86, 2019
Acosta FL Jr et al: Treatment of Enneking stage 3 aggressive vertebral hemangiomas with intralesional spondylectomy: report of 10 cases and review of the literature. J Spinal Disord Tech. 24(4):268-75, 2011
Ropper AE et al: Primary vertebral tumors: a review of epidemiologic, histological, and imaging findings, Part I: benign tumors. Neurosurgery. 69(6):1171-80, 2011
Singh P et al: Treatment of vertebral hemangiomas with absolute alcohol (ethanol) embolization, cord decompression, and single level instrumentation: a pilot study. Neurosurgery. 68(1):78-84; discussion 84, 2011
Alexander J et al: Vertebral hemangioma: an important differential in the evaluation of locally aggressive spinal lesions. Spine (Phila Pa 1976). 35(18):E917-20, 2010
Hurley MC et al: Preoperative Onyx embolization of aggressive vertebral hemangiomas. AJNR Am J Neuroradiol. 29(6):1095-7, 2008
Bandiera S et al: Symptomatic vertebral hemangioma: the treatment of 23 cases and a review of the literature. Chir Organi Mov. 87(1): 1-15, 2002
Gabal AM: Percutaneous technique for sclerotherapy of vertebral hemangioma compressing spinal cord. Cardiovasc Intervent Radiol. 25(6): 494-500, 2002
Murugan L et al: Management of symptomatic vertebral hemangiomas: review of 13 patients. Neurol India. 50(3): 300-5, 2002
Bas T et al: Efficacy and safety of ethanol injections in 18 cases of vertebral hemangioma: a mean follow-up of 2 years. Spine. 26(14): 1577-82, 2001
Baudrez V et al: Benign vertebral hemangioma: MR-histological correlation. Skeletal Radiol. 30(8): 442-6, 2001
Miszczyk L et al: The efficacy of radiotherapy for vertebral hemangiomas. Neoplasma. 48(1):82-4, 2001
Cross JJ et al: Imaging of compressive vertebral haemangiomas. Eur Radiol. 10(6):997-1002, 2000
Doppman JL et al: Symptomatic vertebral hemangiomas: treatment by means of direct intralesional injection of ethanol. Radiology. 214(2): 341-8, 2000
Lee S et al: Extraosseous extension of vertebral hemangioma, a rare cause of spinal cord compression. Spine. 24(20): 2111-4, 1999
Pastushyn AI et al: Vertebral hemangiomas: diagnosis, management, natural history and clinicopathological correlates in 86 patients. Surg Neurol. 50(6): 535-47, 1998
Griffith JF et al: Clinics in diagnostic imaging (25). Aggressive vertebral haemangioma. Singapore Med J. 38(5): 226-30, 1997
Jayakumar PN et al: Symptomatic vertebral haemangioma: endovascular treatment of 12 patients. Spinal Cord. 35(9): 624-8, 1997
Sakata K et al: Radiotherapy of vertebral hemangiomas. Acta Oncol. 36(7):719-24, 1997
Ide C et al: Vertebral haemangiomas with spinal cord compression: the place of preoperative percutaneous vertebroplasty with methyl methacrylate. Neuroradiology. 38(6): 585-9, 1996
Guedea F et al: The role of radiation therapy in vertebral hemangiomas without neurological signs. Int Orthop. 18(2): 77-9, 1994
Fox MW et al: The natural history and management of symptomatic and asymptomatic vertebral hemangiomas. J Neurosurg. 78(1): 36-45, 1993
Laredo JD et al: Vertebral hemangiomas: fat content as a sign of aggressiveness. Radiology. 177(2):467-72, 1990
Nguyen JP et al: Vertebral hemangiomas presenting with neurologic symptoms. Surg Neurol. 27(4):391-7, 1987
Nicola N et al: Vertebral hemangioma: retrograde embolization-stabilization with methyl methacrylate. Surg Neurol. 27(5):481-6, 1987
Ross JS et al: Vertebral hemangiomas: MR imaging. Radiology. 165(1):165-9, 1987