title: Combined dynamic contrast-enhancement and serial 3D-subtraction analysis in magnetic resonance imaging of osteoid osteomas.
abstract: The purpose of this study was to retrospectively correlate the results of dynamic contrast-enhanced magnetic resonance imaging (MRI) with histological and clinical diagnoses in patients with osteoid osteomas. Fifty-four patients with the MR diagnosis of osteoid osteoma were studied. MRI (1.5 Tesla) consisted of thin-section STIR sequences, dynamic 3D T1 gradient echo sequences during application of contrast material, and high-resolution postcontrast T1 spin echo sequences with fat saturation (maximum voxel size 0.6 x 0.6 x 3.0 mm). Evaluation was focused on serial image subtraction during the early phase after contrast injection and on time-intensity curves. The surrounding edema was helpful in finding the nidus in each lesion. In 49 of 54 patients (90.7%), the diagnosis of osteoid osteoma was certain or highly probable (sensitivity 1.0, positive predictive value 0.91). A total of 38 of 54 osteoid osteomas were histologically proven. Five MRI diagnoses were regarded as false positives. A similar proportion has been reported for computed tomography. Tailored high-resolution MR examinations with dynamic contrast enhancement can reliably diagnose osteoid osteomas and exactly localize the nidus without radiation exposure. We propose a stepwise approach with STIR sequences, dynamic contrast-enhanced scanning, and high-resolution postcontrast T1 spin echo sequences with fat saturation.
authors.affiliation: Department of Paediatric Radiology, Klinikum Stuttgart Olgahospital, Bismarckstr. 8, 70176, Stuttgart, Germany. t.vonkalle@klinikum-stuttgart.de
authors.forename: T
authors.initials: T
authors.lastname: von Kalle
authors.forename: M
authors.initials: M
authors.lastname: Langendörfer
authors.forename: F F
authors.initials: FF
authors.lastname: Fernandez
authors.forename: P
authors.initials: P
authors.lastname: Winkler
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D001859:Bone Neoplasms / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D010017:Osteoma, Osteoid / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D055815:Young Adult
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA