Çocuk ve Adölesanlarda Osteoid Osteomaların Görüntüleme Bulguları, Tanıda BT ve MRG'nin Yeri: Tek Merkez Deneyimi

Zehra Filiz Karaman
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Abstract

Objective: To analyze osteoid osteomas of the pediatric age group, assess the distribution of lesions, and radiological findings, and compare the ability of Computerized Tomography (CT) and Magnetic Resonance Imaging (MRI) in detecting the tumor.Material and Methods: Forty-four lesions of osteoid osteoma in children and adolescents were retrospectively analyzed using hospital files and institutional picture archiving and communication systems. Age, gender, treatment choices, modality used for diagnosis, tumor site, location within the bone, presence of calcified nidus, perilesional reactive sclerosis, cortical thickening, perilesional bone marrow edema, and joint effusion were documented.Results: Twenty-nine males and 15 females with a median age of 15.00 (range: 4-18 years) were included in the study. All of the lesions were located in the appendicular skeleton. No axial skeletal involvement was found. Forty out of 44 lesions were located in the long bones. One was localized in the patella, 2 of them in the talus and 1 in the calcaneus. Thirty-four out of forty long bone involvement were in lower extremities. Six cases were located intraarticularly and joint effusion was seen in the involved joint. CT was available in all patients and MRI was available in 18 patients. CT was the first choice of cross-sectional imaging modality in 35 patients, and MRI was the first choice in 9 patients. MRI was successful in only 56% of the cases in characterizing osteoid osteomas. CT was accurate to characterize all osteoid osteoma lesions.Conclusion: CT is more successful than MRI in detecting and characterizing osteoid osteomas. Intraarticular osteoid osteoma must be kept in mind in differential diagnosis, evaluating joint synovitis in children and adolescents.
目的:分析儿童年龄组骨样骨瘤,评估病变分布和影像学表现,比较CT和MRI对肿瘤的检测能力。材料和方法:回顾性分析44例儿童和青少年的骨样骨瘤病变,使用医院档案和机构图片存档和通讯系统。记录年龄、性别、治疗选择、诊断方式、肿瘤部位、骨内位置、钙化病灶的存在、病灶周围反应性硬化、皮质增厚、病灶周围骨髓水肿和关节积液。结果:纳入研究的患者男性29例,女性15例,中位年龄15.00岁(范围4-18岁)。所有病变均位于附肢骨骼。未发现轴骨受累。44个病变中有40个位于长骨。1个位于髌骨,2个位于距骨,1个位于跟骨。40例长骨受累中有34例发生在下肢。6例位于关节内,受累关节可见关节积液。所有患者均行CT检查,18例患者行MRI检查。35例患者首选CT, 9例首选MRI。MRI诊断骨样骨瘤的成功率仅为56%。CT对所有骨样骨瘤病变的诊断均准确。结论:CT对骨样骨瘤的诊断和表征比MRI更有效。在鉴别诊断和评估儿童和青少年的关节滑膜炎时,必须牢记关节内骨样骨瘤。
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