Chen Keyuan, Tian Chunyan, Yang Shaomin, Han Songbo, Jiang Liang, Wei Feng, Yuan Huishu, Liu Xiaoguang, Liu Zhongjun
Orthopaedic Department, Peking University Third Hospital, Beijing, China; Peking University Health Science Center, Beijing, China.
Department of Radiology, Peking University Third Hospital, Beijing, China.
World Neurosurg. 2021 Jan;145:e209-e215. doi: 10.1016/j.wneu.2020.10.014. Epub 2020 Oct 13.
Spine osteoblastomas (OBs) are relatively rare. In contrast to osteoid osteoma, radiologic and clinical manifestations of OB can be varied and atypical. Typical radiographic features in spinal OB include peritumoral bone sclerosis, bone marrow edema, and soft tissue edema. Atypical radiographic features include lesions involving ≥3 segments, lesions with extensive (≥3 segments) bone sclerosis, excessive edema (≥3 segments) of soft tissue and bone marrow, no intralesional calcification, and location in the vertebral body only. The aim of this study was to identify typical and atypical features of OB.
Pretreatment computed tomography scans and magnetic resonance imaging were reviewed retrospectively. Percutaneous biopsies were performed to confirm pathology in atypical cases.
A total of 50 images from patients with diagnosed OB were reviewed. Atypical radiographic features were found in 18 cases (36%). Pathologic diagnosis was confirmed as OB in 86.2% (25/29) cases after percutaneous computed tomography-guided biopsy.
Our results show that >30% of spinal OB cases might have atypical radiographic features. In cases with atypical radiographic features, computed tomography-guided biopsies are recommended.
脊柱骨母细胞瘤（OB）相对罕见。与骨样骨瘤不同，OB的影像学和临床表现可能多种多样且不典型。脊柱OB的典型影像学特征包括肿瘤周围骨质硬化、骨髓水肿和软组织水肿。非典型影像学特征包括累及≥3个节段的病变、伴有广泛（≥3个节段）骨质硬化的病变、软组织和骨髓过度水肿（≥3个节段）、瘤内无钙化以及仅位于椎体的病变。本研究的目的是确定OB的典型和非典型特征。
回顾性分析治疗前的计算机断层扫描（CT）和磁共振成像（MRI）。对非典型病例进行经皮活检以确诊病理。
共回顾了50例确诊为OB患者的影像资料。18例（36%）发现有非典型影像学特征。经皮CT引导下活检后，86.2%（25/29）的病例病理诊断确诊为OB。
我们的结果表明，超过30%的脊柱OB病例可能具有非典型影像学特征。对于具有非典型影像学特征的病例，建议进行CT引导下活检。
