Woertler K, Brinkschmidt C
Department of Radiology, Technische Universität, Munich, Germany.
Acta Radiol. 2002 May;43(3):336-9. doi: 10.1080/j.1600-0455.2002.430318.x.
To analyze the imaging features of subperiosteal aneurysmal bone cyst.
The imaging material of 6 patients with biopsy-proved subperiosteal aneurysmal bone cyst was reviewed. Evaluation included patient demographics, lesion location and size, radiographic features, and intrinsic characteristics on CT and MR images. Review of histologic specimens was carried out by an experienced musculoskeletal pathologist.
All lesions were located at the surface of long tubular bones (femur 3, tibia 2, humerus 1): 3 involved the diaphysis, 2 the dia/metaphysis, and 1 exclusively the metaphysis. Lesion size ranged from 2.5 to 6 cm in maximum diameter. Radiographs and CT images always showed a superficial bone defect, which on radiographs demonstrated irregular margins in 4 cases. All lesions caused an interrupted periosteal reaction (shell 3, trabeculated shell 1, Codman angle 2). MR images always showed a multicystic appearance with a hypointense rim, contrast-enhancing cyst walls, and fluid levels. Edema of adjacent soft tissues was present in all cases.
Aneurysmal bone cyst in a subperiosteal location can demonstrate an aggressive radiographic appearance. MR imaging appears to be most valuable in the differential diagnosis, since it can demonstrate typical morphological features of the underlying process.
分析骨膜下动脉瘤样骨囊肿的影像学特征。
回顾6例经活检证实为骨膜下动脉瘤样骨囊肿患者的影像学资料。评估内容包括患者人口统计学信息、病变位置和大小、放射学特征以及CT和MR图像的内在特征。由一位经验丰富的肌肉骨骼病理学家对组织学标本进行复查。
所有病变均位于长管状骨表面（股骨3例，胫骨2例，肱骨1例）：3例累及骨干，2例累及干骺端/骨干，1例仅累及干骺端。病变最大直径范围为2.5至6厘米。X线片和CT图像均显示骨表面有缺损，其中4例X线片显示边缘不规则。所有病变均导致骨膜反应中断（3例呈壳状，1例呈小梁状壳，2例见Codman三角）。MR图像始终显示为多囊性表现，有低信号边缘、强化的囊肿壁及液平面。所有病例均有相邻软组织水肿。
骨膜下位置的动脉瘤样骨囊肿在放射学上可表现出侵袭性外观。MR成像在鉴别诊断中似乎最具价值，因为它能显示潜在病变的典型形态特征。
