Abstract
ObjectiveTo investigate the values of multimodal imaging approaches in the diagnosis of spinal osteoblastomas with an emphasis on MRI findings.Materials and methodsWe retrospectively evaluated the imaging findings of 35 patients with spinal osteoblastomas. The imaging methods included radiography, whole-body bone scintigraphy (WBBS), CT and MRI.ResultsRadiography detected 87.1% (27/31) of the lesions; WBBS demonstrated increased radionuclide activity in all the lesions. CT could precisely show and localize all niduses, and calcification was always detected. MRI usually could adequately delineate the niduses of osteoblastomas, especially on T2WI (88.2%; 30/34). 71.9% (23/32) of osteoblastomas were surrounded with moderate or extensive bone marrow edema (BME) with soft tissue edema (STE). STE always extended along the muscle bundle adjacent to the lesion; there was no subcutaneous fat involvement. BME was eccentrically distributed in the vertebral body and spread inward from the sides of the nidus. The extent of BME in the vertebral body tended to be inversely proportional to the distance from the nidus. In addition, rare magnifications of osteoblastoma including multifocal diseases (n = 2), vertebra plana (n = 1) or with aneurysmal bone cysts (n = 6) were also observed in our study.ConclusionsIn patients showing moderate or extensive BME together with STE on MRI, both CT and MRI should be used to confirm nidus presence. The above-mentioned characteristics of edema on MRI of patients with spinal osteoblastoma are helpful in not only localizing the nidus, but also enhancing the diagnostic confidence.
Highlights
Osteoblastomas are rare and locally aggressive intermediate tumors that account for approximately 1% of all primary bone tumors [1, 2]
In this study, we investigate the values of multimodal imaging approaches in the diagnosis of spinal osteoblastomas with an emphasis on MRI findings
All niduses were larger than 20 mm in our study, except for one lesion in a multifocal osteoblastoma patient with the diameter of 9 mm
Summary
Osteoblastomas are rare and locally aggressive intermediate tumors that account for approximately 1% of all primary bone tumors [1, 2]. The imaging features of osteoblastomas are largely anecdotal since the related literature is restricted to either case reports or small case series. The largest study on multimodal imaging approaches for diagnosing osteoblastomas was reported (Nemoto et al in 1990 [3]). Shaikh et al reported 11 cases of spinal osteoblastoma, which may be the largest number of such cases in which MRI application has been reported [7]. It is very important to further explore the MRI features of spinal osteoblastoma in a larger sample study. To this end, in this study, we investigate the values of multimodal imaging approaches in the diagnosis of spinal osteoblastomas with an emphasis on MRI findings
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