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

Abstract

Amaç: Pediatrik yaş grubundaki osteoid osteomaları analize ederek, olguların demografik özellikleri, lezyonların radyolojik bulgularını tespit etmek, Bilgisayarlı Tomografi ve Manyetik Rezonans Görüntüleme (MRG)’nin tanıdaki yerini belirlemektir.

Gereç ve Yöntemler: Kurumsal hasta bilgi sistemi ve görüntüleme arşiv sistemi kullanılarak 44 çocuk ve adolesanda tespit edilen osteoid osteoma lezyonu retrospektif olarak analiz edilmiştir. Yaş, cinsiyet dağılımı, tercih edilen tedavi seçeneği, tanıda tercih edilen kesitsel görüntüleme modalitesi (MRG, BT), tümör yeri, tümörün kemikteki lokalizasyonu, kalsifiye nidus varlığı, perilezyonal reaktif skleroz, kortikal kalınlaşma, perilezyonal kemik iliği ödemi ve eklem effüzyonu varlığı araştırılmıştır.

Bulgular: 4-18 yaş aralığında 29 erkek, 15 kız hasta çalışmaya dahil edildi. Lezyonların tümü apendiküler iskelet yerleşimli olup aksial iskelet tutulumu saptanmadı. Kırkdört lezyondan 40’ı uzun kemiklerde yerleşmişti. Bir lezyon patella, iki lezyon talus, bir lezyon kalkaneus yerleşimli idi. Kırk uzun kemik tutulumunun 34’ü alt ekstremiteleri tutmuştu. Altı olgu intraartiküler yerleşimli olup etkilenen eklemde effüzyon artmı vardı. Tüm olgularda BT ile değerlendirme yapılırken 18 olguda MRG ile de değerlendirme yapılmıştı. Öncelikli tercih edilen kesitsel görüntüleme modalitesi 35 olguda, BT iken 9 olguda MRG idi. BT tüm osteoid osteoma lezyonlarını doğru olarak tanırken, MRG’nin lezyonları tanımadaki başarısı %56 idi.

Sonuç: Osteoid osteomayı tespit etmede ve lezyonu karakterize etmede BT, MRG’den daha başarılı bulunmuştur. Çocuk ve adolesanlarda eklem effüzyonu varlığında ayırıcı tanıda intraartiküler osteoid osteoma da akılda bulundurulmalıdır.

Keywords

• osteoid osteoma
• çocuk
• radyoloji
• tanısal görüntüleme

IMAGING FINDINGS OF OSTEOID OSTEOMAS IN CHILDREN AND ADOLESCENTS, CT VERSUS MRI: A SINGLE CENTER EXPERIENCE

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.

Keywords

• osteoid osteoma
• child
• radiology
• diagnostic imaging

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