Sandomenico F, Cappabianca S, Iovino M, Conforti R, Cinque T, Del Vecchio W
Istituto di Scienze Radiologiche, Seconda Università degli Studi, Napoli.
Radiol Med. 1996 Nov;92(5):525-9.
Aneurysmal bone cysts (ABC) are relatively uncommon benign expansile osteolytic lesions characterized by multiple cavities with serum-blood levels and delimited by a thin periosteal external border. The differential diagnosis is difficult to make with conventional radiography, while CT and MRI are elective techniques. Ten patients with ABC (7 central and 3 eccentric lesions) were examined with CT and MRI. Four cysts were localized at the proximal femur, 2 in calcaneal, 2 in vertebral (cervical and dorsal), 1 in tibial and 1 in iliac sites. Diagnostic criteria were the presence of fluid-fluid levels and a thin hyperdense peripheral border at CT, while hyperintense cavities on T2-weighted sequences, fluid-fluid levels, pseudodiverticular features and a low-signal border were found at MRI. Intralesional levels were detected in 9 patients at CT and in 10 at MRI; the 3 peripheral cysts exhibited a hyperdense extraosseous border at CT, corresponding to the periosteal shell, considered a benignity sign. To conclude, CT and MRI, thanks to their high resolution, clearly depict the anatomopathologic features of ABC, thus allowing this type of lesion to be differentiated from other benign and malignant osteolytic lesions.
骨动脉瘤样囊肿(ABC)是相对少见的良性膨胀性溶骨性病变,其特征为多个含有血清样液体的腔隙,并由一层薄的骨膜外缘包绕。常规X线摄影很难做出鉴别诊断,而CT和MRI是可选择的检查技术。对10例ABC患者(7例中心性病变和3例偏心性病变)进行了CT和MRI检查。4个囊肿位于股骨近端,2个位于跟骨,2个位于椎体(颈椎和胸椎),1个位于胫骨,1个位于髂骨部位。诊断标准为CT上存在液-液平面和薄的高密度外周边界,而MRI上T2加权序列可见高信号腔隙、液-液平面、假性憩室样表现及低信号边界。9例患者CT上检测到病变内液-液平面,10例患者MRI上检测到;3例外周囊肿在CT上显示高密度的骨外边界,对应于骨膜壳,被认为是良性征象。总之,CT和MRI由于其高分辨率,能清晰显示ABC的解剖病理特征,从而使这类病变能够与其他良性和恶性溶骨性病变相鉴别。