Liu Patrick T, Chivers F Spencer, Roberts Catherine C, Schultz Christopher J, Beauchamp Christopher P
Department of Radiology, Mayo Clinic Scottsdale, 13400 E Shea Blvd, Scottsdale, AZ 85259, USA.
Radiology. 2003 Jun;227(3):691-700. doi: 10.1148/radiol.2273020111.
To compare dynamic gadolinium-enhanced T1-weighted magnetic resonance (MR) imaging with nonenhanced T1-weighted and T2-weighted MR imaging and thin-section computed tomography (CT) for the demonstration of osteoid osteomas.
The images of 11 patients with pathologically proven osteoid osteomas who underwent nonenhanced MR imaging, dynamic gadolinium-enhanced MR imaging, and CT were retrospectively reviewed. Images obtained with all three techniques were scored for conspicuity of the osteoid osteoma relative to the surrounding bone. Time-enhancement curves were generated from signal intensity measurements of these lesions and the adjacent bone marrow. The mean imaging scores of the four techniques were compared, and the statistical significance was calculated by using a linear model with terms for method and patient. Pairwise comparisons were made by using the Tukey-Kramer adjustment for multiple comparisons.
Compared with CT, dynamic gadolinium-enhanced MR imaging demonstrated the osteoid osteoma equally well in eight of 11 patients and with better conspicuity in three of 11 patients, although this difference was not statistically significant (P =.69). The dynamic gadolinium-enhanced MR images demonstrated the osteoid osteomas significantly better than the nonenhanced T1-weighted (P <.001) and T2-weighted (P <.001) MR images. On the dynamic gadolinium-enhanced MR images, nine (82%) of 11 patients had peak enhancement of the osteoid osteoma in the arterial phase with early partial washout, compared with slower, progressive enhancement of the adjacent marrow. This resulted in greatest lesion to marrow contrast material enhancement in the arterial phase. One osteoid osteoma had peak enhancement in the venous phase, and one showed progressive enhancement through all phases to 150 seconds.
Osteoid osteomas can be imaged with greater conspicuity by using dynamic gadolinium-enhanced instead of nonenhanced MR imaging and with conspicuity equal to or better than that obtained with thin-section CT.
比较动态钆增强T1加权磁共振（MR）成像与非增强T1加权和T2加权MR成像以及薄层计算机断层扫描（CT）对骨样骨瘤的显示情况。
回顾性分析11例经病理证实的骨样骨瘤患者的影像资料，这些患者均接受了非增强MR成像、动态钆增强MR成像及CT检查。对采用这三种技术获得的图像，就骨样骨瘤相对于周围骨质的显示清晰度进行评分。通过对这些病变及相邻骨髓的信号强度测量生成时间增强曲线。比较这四种技术的平均影像评分，并使用包含方法和患者项的线性模型计算统计学意义。采用Tukey-Kramer法进行多重比较的两两比较。
与CT相比，动态钆增强MR成像在11例患者中的8例中对骨样骨瘤的显示效果相同，在11例患者中的3例中显示更清晰，尽管这种差异无统计学意义（P = 0.69）。动态钆增强MR图像对骨样骨瘤的显示明显优于非增强T1加权（P < 0.001）和T2加权（P < 0.001）MR图像。在动态钆增强MR图像上，11例患者中有9例（82%）的骨样骨瘤在动脉期出现峰值增强并早期部分廓清，而相邻骨髓的增强则较缓慢且呈渐进性。这导致在动脉期病变与骨髓之间的对比剂增强最大。1例骨样骨瘤在静脉期出现峰值增强，1例在所有阶段直至150秒均呈渐进性增强。
使用动态钆增强而非非增强MR成像可更清晰地显示骨样骨瘤，其清晰度与薄层CT相当或更佳。
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