Department of Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd., Phoenix, AZ 85054, USA.
AJR Am J Roentgenol. 2011 Jan;196(1):168-73. doi: 10.2214/AJR.10.4534.
We have observed that osteoid osteomas are frequently surrounded by thin curvilinear or serpiginous low-density grooves in the surrounding bone on CT examinations. We believe that these grooves represent prominent enlarged feeding arterioles, corresponding to recently published histologic findings. This study was performed to assess the sensitivity and specificity of this vascular groove sign for differentiating osteoid osteomas from other radiolucent bone lesions.
The study group consisted of 42 patients with pathologically proven osteoid osteomas. The control group included 29 patients with radiolucent bone lesions other than osteoid osteomas. Two readers scored CT examinations of these lesions for the presence of the vascular groove sign, defined as one or more radiolucent linear or serpiginous grooves extending from the periosteal surface of bone down to the radiolucent tumor. Sensitivity and specificity values were calculated for each reader. Positive and negative predictive values, p values, and interobserver agreement values were calculated.
The sensitivity of the vascular groove sign for detection of osteoid osteoma was 73.8% for reader 1 and 76.2% for reader 2, specificity was 96.6% for reader 1 and 89.7% for reader 2, positive predictive value was 96.9% for reader 1 and 91.4% for reader 2, and negative predictive value was 71.8% for reader 1 and 72.2% for reader 2. The p value was less than 0.0001 for both readers. The interobserver agreement was very good, with a kappa value of 0.85.
The vascular groove sign is a moderately sensitive but highly specific sign for distinguishing osteoid osteomas from other radiolucent bone tumors on CT.
我们在 CT 检查中观察到，骨样骨瘤周围的骨组织中常常存在纤细的曲线状或蜿蜒状的低密度凹槽。我们认为这些凹槽代表了明显增粗的供血动脉，与最近发表的组织学发现相对应。本研究旨在评估该血管凹槽征在区分骨样骨瘤与其他透亮性骨病变中的敏感性和特异性。
研究组包括 42 例经病理证实的骨样骨瘤患者。对照组包括 29 例非骨样骨瘤的透亮性骨病变患者。两位读者对这些病变的 CT 检查结果进行评分，以评估血管凹槽征的存在情况，该征定义为从骨的骨膜表面延伸至透亮性肿瘤的一个或多个透亮性线性或蜿蜒状凹槽。计算每位读者的敏感性和特异性值。计算阳性和阴性预测值、p 值和观察者间一致性值。
对于读者 1 和读者 2，血管凹槽征对骨样骨瘤的检测敏感性分别为 73.8%和 76.2%，特异性分别为 96.6%和 89.7%，阳性预测值分别为 96.9%和 91.4%，阴性预测值分别为 71.8%和 72.2%。对于两位读者，p 值均小于 0.0001。观察者间一致性非常好，kappa 值为 0.85。
血管凹槽征是一种在 CT 上区分骨样骨瘤与其他透亮性骨肿瘤的中度敏感但高度特异的征象。
