Abstract
BackgroundTo investigate the imaging features of hemangiomas in long tabular bones for better diagnosis.MethodsTwenty-four patients with long bone hemangiomas confirmed by pathology were enrolled. Nineteen patients had plain radiography, fourteen patients had computed tomography (CT) and eleven had magnetic resonance imaging (MRI). The hemangioma was divided into medullary [13], periosteal [6] and intracortical type [5].ResultsAmong 19 patients with plain radiography, eleven patients were medullary, three periosteal, and five intracortical. In the medullary type, the lesion was primarily osteolytic, including five cases with irregular and unclear rims and one lesion having osteosclerotic and unclear rims. In three patients with the periosteal type, the lesion had clear rims with involvement of the cortical bone in the form of bone defect, including two cases with local thickened bone periosteum and one case having expansile periosteum. Five intracortical hemangiomas had intracortical osteolytic lesions with clear margins. Among 14 patients with CT imaging, 8 cases were medullary, three periosteal, and three intracortical. Among 8 medullary hemangiomas, one had ground glass opacity, and seven had osteolytic, expansile lesions like soft tissue density with no calcification. In three periosteal cases, the lesion was osteolytic with thickened periosteum and narrowed medullary cavity. In three intracortical hemangiomas, the lesion was of even soft tissue density with no calcification. Among 11 patients with MRI imaging, seven were medullary, two periosteal, and two intracortical. Among 7 medullary lesions, six were of hypointense signal on T1WI and hyperintensesignal on T2 WI. In two periosteal cases, the periosteum was thickened, with one case being of equal signal, and the other having no signal. Two intracortical hemangiomas were both of slightly low signal on T1WI but hyperintense signal on T2WI.ConclusionsThe long bone hemangiomas had characteristic cystic honeycomb-like presentations in plain radiograph. CT and MRI imagings are helpful for diagnosis of hemangiomas in long bone.
Highlights
To investigate the imaging features of hemangiomas in long tabular bones for better diagnosis
On computed tomography (CT) images, a typical “polka dot” pattern is presented with small foci of sclerosis which stands for the thickened vertically oriented bony trabecula, and areas of low-density soft tissues or abnormal vessels and lipid are intervening between the vertically-oriented trabecula [5]
We presented a series of patients with hemangiomas in the long tubular bones proved by histopathology and analyzed the imaging characteristics so as to increase the diagnostic accuracy for this tumor
Summary
To investigate the imaging features of hemangiomas in long tabular bones for better diagnosis. The lesion is asymptomatic most of the time but may produce symptoms in cases of hematoma formation, epidural extension, vertebral body expansion, or pathological fracture [6,7,8] This neoplasm usually occurs in the vertebra and craniofacial bones, and long tubular bones in four extremities have been infrequently involved [9,10,11]. Hemangiomas have typical high signal intensity on both T1WI and T2WI of magnetic resonance imaging (MRI) because of abundant adipocytes, blood vessels and interstitial edema [5] Radiological characteristics of this tumor are so typical in the spine and skull that radiologists can differentiate it from other forms of bone tumors. We presented a series of patients with hemangiomas in the long tubular bones proved by histopathology and analyzed the imaging characteristics so as to increase the diagnostic accuracy for this tumor
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