Mahnken A H, Nolte-Ernsting C C A, Wildberger J E, Heussen N, Adam G, Wirtz D C, Piroth W, Bücker A, Biesterfeld S, Haage P, Günther R W
Department of Diagnostic Radiology, University of Technology, Pauwelsstrasse 30, 52074 Aachen, Germany.
Eur Radiol. 2003 May;13(5):1118-24. doi: 10.1007/s00330-002-1668-8. Epub 2002 Oct 3.
Our objective was to investigate the accuracy and the diagnostic value of different imaging features of primary aneurysmal bone cysts (ABC) in conventional radiographs and MRI. Conventional radiographs and MR images of 34 patients with a suspected aneurysmal bone cyst were reevaluated by six independent radiologists in a blinded fashion. Morphological features, MR signal characteristics, and contrast enhancement patterns were assessed. Diagnoses were correlated with histology. Sensitivity and specificity of the different imaging findings for each imaging technique were calculated. In 24 patients ABC was histologically proven. In 10 cases diagnoses other than ABC were established. Conventional radiography and MRI each demonstrated a sensitivity of 76.4 and 77.8% with a specificity of 55.0 and 66.7%, respectively. With combined use of both imaging modalities sensitivity and specificity increased to 82.6 and 70%, respectively. The ABC was significantly more often seen as circumscribed lesion with bone expansion, lobulation, septa, and pathological cortical bone reaction than those cases with different diagnoses. Septal contrast enhancement proved to be a useful MR imaging finding in suspected ABC. The combined use of conventional radiographs and MRI revealed the highest sensitivity in the diagnosis of ABC in relation to histology. Magnetic resonance imaging provides improved diagnostic specificity and valuable information on soft tissue changes.
我们的目的是研究原发性骨囊肿（ABC）在传统X线片和MRI中不同影像特征的准确性和诊断价值。34例疑似骨囊肿患者的传统X线片和MR图像由6名独立放射科医生以盲法重新评估。评估形态学特征、MR信号特征和对比增强模式。诊断结果与组织学结果相关。计算每种成像技术不同影像表现的敏感性和特异性。24例患者经组织学证实为ABC。10例确诊为非ABC。传统X线摄影和MRI的敏感性分别为76.4%和77.8%，特异性分别为55.0%和66.7%。两种成像方式联合使用时，敏感性和特异性分别提高到82.6%和70%。与不同诊断的病例相比，ABC更常表现为边界清晰的病变，伴有骨质膨胀、分叶、分隔和病理性皮质骨反应。分隔对比增强在疑似ABC的MR成像中是一个有用的表现。传统X线片和MRI联合使用在ABC组织学诊断中显示出最高的敏感性。磁共振成像提高了诊断特异性，并提供了有关软组织变化的有价值信息。
