title: Aneurysmal bone cyst: value of MR imaging and conventional radiography.
abstract: 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.
authors.affiliation: Department of Diagnostic Radiology, University of Technology, Pauwelsstrasse 30, 52074 Aachen, Germany. mahnken@rad.rwth-aachen.de
authors.forename: A H
authors.initials: AH
authors.lastname: Mahnken
authors.forename: C C A
authors.initials: CC
authors.lastname: Nolte-Ernsting
authors.forename: J E
authors.initials: JE
authors.lastname: Wildberger
authors.forename: N
authors.initials: N
authors.lastname: Heussen
authors.forename: G
authors.initials: G
authors.lastname: Adam
authors.forename: D C
authors.initials: DC
authors.lastname: Wirtz
authors.forename: W
authors.initials: W
authors.lastname: Piroth
authors.forename: A
authors.initials: A
authors.lastname: Bücker
authors.forename: S
authors.initials: S
authors.lastname: Biesterfeld
authors.forename: P
authors.initials: P
authors.lastname: Haage
authors.forename: R W
authors.initials: RW
authors.lastname: Günther
mesh_terms: D000293:Adolescent; D000328:Adult; D017824:Bone Cysts, Aneurysmal / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D003937:Diagnosis, Differential; D018483:Diaphyses / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology*; D005360:Fibula / Q000000981:diagnostic imaging / Q000473:pathology*; D005858:Germany; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010388:Pelvis / Q000000981:diagnostic imaging / Q000473:pathology*; D011237:Predictive Value of Tests; D011856:Radiographic Image Enhancement; D012680:Sensitivity and Specificity; D013977:Tibia / Q000000981:diagnostic imaging / Q000473:pathology*
chemical_list: D003287:Contrast Media