title: Imaging findings of solitary spinal bony lesions and the differential diagnosis of benign and malignant lesions.
abstract: OBJECTIVE
  The purpose of this study was to present the MRI and CT findings of solitary spinal bone lesions (SSBLs) with the aims of aiding the differential diagnoses of malignant tumors and benign lesions, and proposing a diagnostic strategy for obscure SSBLs.
  
  
  METHODS
  The authors retrospectively reviewed the imaging findings of 19 patients with an obscure SSBL on MRI at our hospital from January 1994 to April 2011. The 19 patients were divided to benign groups and malignant groups according to final diagnosis. MRI and CT findings were evaluated and the results of additional work-up studies were conducted to achieve a differential diagnosis.
  
  
  RESULTS
  At final diagnoses, 10 (52.6%) of the 19 SSBLs were malignant tumors and 9 (47.4%) were benign lesions. The malignant tumors included 6 metastatic cancers, 3 multiple myelomas, and 1 chordoma, and the benign lesions included 4 osteomyelitis, 2 hemangiomas, 2 nonspecific chronic inflammations, and 1 giant cell tumor. No MRI characteristics examined was found to be significantly different in the benign and malignant groups. Reactive sclerotic change was observed by CT in 1 (10.0%) of the 10 malignant lesions and in 7 (77.8%) of the 9 benign lesions (p=0.005).
  
  
  CONCLUSIONS
  Approximately half of the obscure SSBLs were malignant tumors. CT and MRI findings in combination may aid the differential diagnosis of obscure SSBLs. In particular, sclerotic change on CT images was an important finding implying benign lesion. Finally, we suggest a possible diagnostic strategy for obscure SSBLs on MRI.
authors.affiliation: Department of Neurosurgery, Pusan National University Hospital, Busan, Korea.
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: In Ho
authors.initials: IH
authors.lastname: Han
authors.forename: In Sook
authors.initials: IS
authors.lastname: Lee
authors.forename: Jung Sub
authors.initials: JS
authors.lastname: Lee
authors.forename: Byung Kwan
authors.initials: BK
authors.lastname: Choi
keywords: CT; Differential diagnosis; MRI; Malignant lesion; Solitary spinal bone lesion; benign lesion