MR Findings of the Osteofibrous Dysplasia

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Abstract

Objective

The aim of this study was to describe MR findings of osteofibrous dysplasia.

Materials and Methods

MR images of 24 pathologically proven osteofibrous dysplasia cases were retrospectively analyzed for a signal intensity of the lesion, presence of intralesional fat signal, internal hypointense band, multilocular appearance, cortical expansion, intramedullary extension, cystic area, cortical breakage and extraosseous extension, abnormal signal from the adjacent bone marrow and soft tissue and patterns of contrast enhancement.

Results

All cases of osteofibrous dysplasia exhibited intermediate signal intensity on T1-weighted images. On T2-weighted images, 20 and 4 cases exhibited heterogeneously intermediate and high signal intensity, respectively. Intralesional fat was identified in 12% of the cases. Internal low-signal bands and multilocular appearance were observed in 91%. Cortical expansion was present in 58%. Intramedullary extension was present in all cases, and an entire intramedullary replacement was observed in 33%. Cortical breakage (n = 3) and extraosseous mass formation (n = 1) were observed in cases with pathologic fractures only. A cystic area was observed in one case. Among 21 cases without a pathologic fracture, abnormal signal intensity in the surrounding bone marrow and adjacent soft tissue was observed in 43% and 48%, respectively. All cases exhibited diffuse contrast enhancement.

Conclusion

Osteofibrous dysplasia exhibited diverse imaging features ranging from lesions confined to the cortex to more aggressive lesions with complete intramedullary involvement or perilesional marrow edema.

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Most cited references 34

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Osteoid osteoma.

Amy Moser, F Gilkey, M Stull … (1991)

Osteoid osteoma is a benign skeletal neoplasm composed of osteoid and woven bone that rarely exceeds 1.5 cm in greatest dimension. The lesion is most commonly located in the cortex of long bones where it is associated with dense, fusiform, reactive sclerosis. Less often, it may be cancellous, where reactive osteosclerosis is usually less intense and may be distant from the lesion. Cancellous lesions are frequently intraarticular (most often in the hip) and may be associated with synovitis and joint effusion. Rarely, osteoid osteomas occur in a subperiosteal location. Patients are usually young, and there is a strong male predominance. Pain is the most common symptom. Radiographs of patients with cortical osteoid osteoma are often diagnostic. Intraarticular lesions, however, may be subtle, and scintigraphy may be required to locate the lesion for subsequent computed tomography (CT). CT is useful to identify and precisely locate the lesion and to provide guidance for percutaneous localization or treatment.

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Aneurysmal bone cyst: value of MR imaging and conventional radiography.

A Mahnken, C. Nolte-Ernsting, J. Wildberger … (2003)

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.

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Telangiectatic osteosarcoma: radiologic-pathologic comparison.

Francis Gannon, Martin Malawer, Daniel Temple … (2003)

To describe the imaging characteristics of a large series of telangiectatic osteosarcomas with pathologic findings for comparison. The authors retrospectively reviewed 40 pathologically confirmed telangiectatic osteosarcomas. Patient demographics and images from radiography (n = 36), bone scintigraphy (n = 17), angiography (n = 4), computed tomography (CT) (n = 25), and magnetic resonance (MR) imaging (n = 27) were evaluated by three authors in consensus for lesion location, size, and intrinsic characteristics. There were 27 men (68%) and 13 women (32%) in the study, with an age range of 4-83 years (mean age, 24 years). Lesions frequently affected the femur, tibia, and humerus. Radiographs showed geographic bone lysis, a wide zone of transition, and matrix mineralization. CT demonstrated low attenuation, MR demonstrated high signal intensity on T2-weighted images, and both demonstrated hemorrhage, which simulated the appearance of aneurysmal bone cyst. Viable sarcomatous tissue surrounding hemorrhagic and/or necrotic regions was best seen at contrast material-enhanced CT and MR imaging, with thick peripheral, septal, and nodular enhancement in all cases. Subtle matrix mineralization in this viable tissue was best seen at CT. An associated soft-tissue mass was also seen in 19 of 25 cases (76%) at CT and in 24 of 27 cases (89%) at MR imaging. CT and MR imaging findings of telangiectatic osteosarcoma often include thick nodular tissue (and matrix mineralization at CT) in a largely hemorrhagic and/or necrotic osseous lesion with an associated soft-tissue mass, which allows distinction from aneurysmal bone cyst.

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Author and article information

Journal

Journal ID (nlm-ta): Korean J Radiol

Journal ID (iso-abbrev): Korean J Radiol

Journal ID (publisher-id): KJR

Title: Korean Journal of Radiology

Publisher: The Korean Society of Radiology

ISSN (Print): 1229-6929

ISSN (Electronic): 2005-8330

Publication date (Print): Jan-Feb 2014

Publication date (Electronic): 08 January 2014

Volume: 15

Issue: 1

Pages: 114-122

Affiliations

[1 ]Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea.

[2 ]Department of Radiology, Seoul National University College of Medicine, Seoul 110-744, Korea.

[3 ]Department of Radiology, Seoul National University Bundang Hospital, Seongnam 463-707, Korea.

[4 ]Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea.

[5 ]Department of Radiology, Kyung Hee University College of Medicine, Seoul 130-872, Korea.

[6 ]Department of Radiology, Korea University College of Medicine, Seoul 136-705, Korea.

[7 ]Department of Pathology, College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea.

[8 ]Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea.

Author notes

Corresponding author: Won-Hee Jee, MD, Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 137-701, Korea. Tel: (822) 2258-6238, Fax: (822) 599-6771, whjee@ 123456catholic.ac.kr

Article

DOI: 10.3348/kjr.2014.15.1.114

PMC ID: 3909842

PubMed ID: 24497800

SO-VID: 75694fee-b01b-4a83-af85-390cbc3313ca

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

MR Findings of the Osteofibrous Dysplasia

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Abstract

Objective

Materials and Methods

Results

Conclusion

Related collections

Stroke MRI

Most cited references 34

Osteoid osteoma.

Aneurysmal bone cyst: value of MR imaging and conventional radiography.

Telangiectatic osteosarcoma: radiologic-pathologic comparison.

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