MR Imaging of Osteoid Osteoma of the Talus

Yeager, Bradford A.; Schiebler, Mark L.; Wertheim, Steven B.; Schmidt, Richard H.; Torg, Joseph S.; Perosio, Patricia M.; Dalinka, Murray K.

doi:10.1097/00004728-198709000-00038

Cited by 31 publications

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“…Within the group of patients with benign disorders marrow edema was specifically found in association with chondroblastoma, osteoid osteoma, and osteoblastoma. Similar findings have been reported or demonstrated in ,illustrations of these lesions elsewhere [20,21,26,36,39,[40][41][42]= The :high frequency of marrow edema we encountered in patients with chondroblastoma of bone agrees with findings in previous reports [21,26]. In our patients, osteosarcoma was also the most common malignant tumor accompanied by intraosseous edema [7].…”

Section: Discussionsupporting

confidence: 92%

“…On MR studies, the presence of marrow edema is suggested by indistinct areas of intermediate SI on Tl-weighted images that increase on T2-weighted, fat saturation, and STIR sequences [7,8,20,28,30,[34][35][36]38].…”

Section: Discussionmentioning

confidence: 99%

“…The capability of MR to distinguish benign from malignant musculoskeletal lesions remains to this day controversial [11, 121. Soft tissue edema accompanying musculoskeletal lesions has been reported earlier [4,7,8,[11][12][13][14][15][16][17][18][19][20][21]. More recently, several studies have mentioned the presence of marrow edema adjacent to bone tumors and several other conditions, indicated by a change in signal intensities on MR images [5,8,14,18,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36]. None of these studies, concerning bone tumors or tumor-like lesions, focused specifically on the incidence and quantity of intraosseous edema or the potential impact of the presence of edema on the differentiation of lesions.…”

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MR imaging of edema accompanying benign and malignant bone tumors

et al. 1994

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To evaluate the incidence, quantity, and presentation of intra- and extraosseous edema accompanying benign and malignant primary bone lesions, the magnetic resonance (MR) studies of 63 consecutive patients with histologically proven primary bone tumors were reviewed. MR scans were assessed for the presence and quantity of marrow and soft tissue edema and correlated with peroperative findings, resected specimens and follow-up data. The signal intensity and enhancement of tumor and edema prior to and after intravenous administration (if any) of gadolinium-labeled diethylene triamine pentaacetate (Gd-DTPA) was analyzed. Marrow edema was encountered adjacent to 8 of 39 malignant tumors and 14 of 24 benign lesions. Soft tissue edema was found accompanying 28 of 39 malignancies and 10 of 24 benign disorders. On unenhanced T1-weighted MR images tumor and edema were difficult to differentiate. Tumor inhomogeneity made this differentiation easier on T2-weighted sequences. In 36 patients the contrast medium Gd-DTPA was used. Edema was present in 27 of these patients and the respective enhancement of tumor and edema could be compared. Edema always enhanced homogeneously, and in most cases it enhanced to a similar degree as or more than tumor. Marrow and, more specifically, soft tissue edema is a frequent finding adjacent to primary bone tumors. The mere presence and quantity of marrow and soft tissue edema are unreliable indicators of the biologic potential of a lesion. Unenhanced MR scans cannot always differentiate between tumor and edema, but the administration of Gd-DTPA is of assistance in differentiating tumor from edema.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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MR imaging of edema accompanying benign and malignant bone tumors

et al. 1994

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“…Possible mechanisms generating edema surrounding tumors have been described [21] and the edema represents a nonspecific response of tissue to a stimulus. Histological examination of these areas revealed edematous fluid together with inflammatory cells [18,19], but this inflammatory response was not invariably found in other series [16].…”

Section: Discussionmentioning

confidence: 77%

“…These appearances can be confusing, although the mere presence and quantity of marrow and soft tissue edema are unreliable indicators of the biological potential of a lesion [16]. Features indicative of tumor-associated bone marrow edema are frequently found in benign disorders such as osteoid osteoma, osteoblastoma and chondroblastoma [16,17,18,19,20]. Weatherall et al [7] found 19 of 22 patients with chondroblastoma had bone marrow edema and a periosteal reaction was demonstrated in 18 patients, while Jee et al [6] reported 82% with similar features.…”

Section: Discussionmentioning

confidence: 99%

Chondroblastoma and clear cell chondrosarcoma: radiological and MRI characteristics with histopathological correlation

Kaim¹,

Hügli²,

Bonél³

et al. 2001

Skeletal Radiol

115

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Objective: To analyze and compare the radiological and magnetic resonance imaging (MRI) appearances of chondroblastoma and clear cell chondrosarcoma with histopathological correlation. Design and patients: Twelve patients with histologically proven chondroblastoma and of another four patients with clear cell chondrosarcoma were investigated by radiographs and MRI (T1-, T2-weighted sequences, intravenous gadolinium application). Additionally, the clinical and radiologic data of seven cases of clear cell chondrosarcoma without available MRI were considered. The localization, calcification of tumor matrix, periosteal reaction, cortical bone and patterns of bone destruction were analyzed according to the Lodwick radiological grading system (LRGS). The signal intensity on T1-and T2-weighted sequences, characteristics of contrast enhancement, associated bone marrow edema, soft tissue reaction and joint involvement were evaluated. Histopathological specimens were available in all cases. Results: The age of patients with chondroblastoma (range 15-59 years, mean 22.3 years) was lower than that of those with clear cell chondrosarcoma (range 19-61 years, mean 36.6 years), and the lesions were smaller in the chondroblastoma group (range 1-4 cm, mean 2.3 cm) than in patients with clear cell chondrosarcoma (range 3-7.5 cm, mean 5.2 cm). The chondroblastomas were more confined to the epiphysis (10/12) than the clear cell chondrosarcomas. All chondroblastomas and clear cell chondrosarcomas except one were classified as grade 1A or 1B according to the LRGS; one clear cell chondrosarcoma was judged as grade 2. Signal intensity of the tumors on MRI was very heterogeneous in both groups. High signal intensity on T2-weighted MR images in chondroblastoma mostly corresponded to areas with aneurysmal bone cyst components and in clear cell chondrosarcoma to islands of hyaline cartilage. Contrast enhancement occurred in all tumors and tended to be more intense with clear cell chondrosarcoma. Chondroblastoma was more frequently associated with bone marrow edema (11/12), periosteal reaction (10/12), soft tissue reaction (7/12) and synovitis (3/12). Conclusion: Chondroblastoma occurs in younger patients, is smaller than clear cell chondrosarcoma and is more confined to the epiphysis. The overlap of signal intensity and contrast enhancement patterns does not allow a reliable differentiation of the two tumors by MRI. Chondroblastomas are typically associated with bone marrow edema, periosteal reaction and soft tissue reaction.

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