Semi-quantitative interpretation of the bone scan in metabolic bone disease

Certain easily recognisable features are commonly seen in the bone scans of patients with metabolic bone disorders. Seven such features have been numerically graded by three independent observers in the scans of 100 patients with metabolic bone disease and of 50 control subjects. The total score for each patient is defined as the metabolic index. The mean metabolic index for each group of patients with metabolic bone disease is significantly greater than that for the control group (P<0.001).     

Assessment of bone mineral content in the internal bone volume

A method for assessing values related to bone density and mass is described. Mean attenuation and pixel area are measured in pixels selected on the basis of CT units. The method is to a large extent computerized and not dependent on manual positioning or outlining of a region of interest. Because it is not dependent on a comparatively large volume of homogeneous bone it can be used to make assessments even in very heterogeneous bones including cortical bone. The method is adaptable for measurement in all parts of the skeleton and values related to both bone density (DRV) and bone mass (MRV) are derived. The measurements in the femoral condyles were shown to have a precision of approximately 0.25 to 0.30 Z-score units (standard deviation of the measurements expressed in Z-score units). The agreement between chemically analyzed calcium density (weight of calcium per volume) and DRV was little less than 0.50 Z-scores and 0.30 Z-scores for the chemically determined calcium mass and the MRV. The agreement with mechanical bone strength was 0.78 Z-scores for DRV and 0.64 for the MRV. Altering scan parameters or measuring approaches gave systematic differences in measurements. There were, however, good linear correlations between the measurements which show that these different measuring approaches essentially gave identical measurements.     

Aneurysmal bone cyst of the temporal bone

Aneurysmal bone cyst (ABC) of the temporal bone is rare. The nature of the underlying disorder that converted into the ABC might, however, be difficult to ascertain on imaging as well as on histopathology. The unusual CT and MRI findings in a case of ABC of the temporal bone are presented. This had transdural intracerebral spread with a large component of solid enhancing matrix but no peripheral calcific rim. The patient was an adult of 45 years with a history of headache for more than 1 year.     

Aneurysmal bone cyst of the temporal bone

Summary Aneurysmal bone cysts occurring within the calvarium are uncommon. The following case report describes the radiological and pathological findings of a temporal bone aneurysmal bone cyst with intra- and extracranial manifestations. The pertinent literature is reviewed.     

Aneurysmal bone cyst of the frontal bone

BACKGROUND: Aneurysmal bone cyst (ABC) is a benign, expansive, osteolytic lesion that mainly occurs in young people, and involves the skull bones only exceptionally. The origin of ABC is controversial: secondary reactive bone lesion, or primary disease that represents an independent nosological entity. Blunt head trauma was suggested as a possible etiological factor. CASE REPORT: A case of a 19-year-old man with primary ABC of the right frontal bone was reported. The lesion was totally excised through frontal craniotomy, and the skull bone defect primarily reconstructed with an acrilate cranioplasty. Five years after the surgery, the patient was without signs of local recurrence. CONCLUSION: Clinical and neuroradiological presentation of the skull ABC was not specific. Pathohistology confirmed the diagnosis. Total excision was the treatment of choice.     

False positive bone scan in bone tumors of the lower limb

When examined using bone scanning agents, eight out of nine patients with lower limb malignancy, and neither of two affected in the upper limb showed a pathologic focus of isotope uptake in an area distal to the tumor.On pathologic examination the positive findings proved false. Such misleading results were found to be avoidable if a tumor-seeking agent instead of a bone scanning one is used.     

Aneurysmal bone cyst of the ethmoid bone

Aneurysmal bone cysts is a benign, slow growing expansile lesion usually found in long bones or vertebrae. Only 5 cases of ABC of the ethmoid bone have been reported in the literature. Plain radiographs are not specific. CT and MRI are very useful to depict the extent of the lesion and demonstrate the presence of blood-fluid levels, which is a characteristic finding of ABC. We present one atypical case of ABC of the ethmoid bone in a 15-year-old female characterised by its extensive involvement and its rare location.     

Aneurysmal bone cyst of the temporal bone

Aneurysmal bone cysts are benign fibrosseous lesions of the bone that are rarely detected in the temporal bone. Seventeen cases of aneurysmal bone cysts with histological confirmation involving the temporal bone were reported in the literature. We report a case of left temporal aneurysmal bone cyst in a 52-year-old male with the clinical findings of periauricular painful swelling, decreased hearing, and facial paralysis. A magnetic resonance image of the patient showed a well-circumscribed multi-loculated expansile lesion of the left temporal bone during the first admission to the hospital. The lesion recurred 1 year after the subtotal resection with a more solid appearance. In addition, we review the literature for these rare lesions.     

False positive bone scan in bone tumors of the lower limb.

When examined using bone scanning agents, eight out of nine patients with lower limb malignancy, and neither of two affected in the upper limb showed a pathologic focus of isotope uptake in an area distal to the tumor. On pathologic examination the positive findings proved false. Such misleading results were found to be avoidable if a tumor-seeking agent instead of a bone scanning one is used.     

N-MID、β-CTx与肿瘤骨转移骨显像对比分析

目的:对比分析肿瘤骨转移核素骨显像与骨代谢标志物N-MID、β-CTx的临床应用价值。方法:依据骨显像将恶性肿瘤患者分为无骨转移组和骨转移组,采用Soloway分级将骨转移组病例分为4级,分析N-MID、β-CTx的变化情况。结果:骨转移组β-CTx约为0.42 ng/ml,明显高于对照组0.27 ng/ml(P<0.01);各级骨转移组β-CTx水平分别为:对照组0.24±0.17 ng/ml,1级骨转移组0.31±0.11 ng/ml,2级骨转移组0.56±0.19 ng/ml,3级骨转移组0.81±0.13 ng/ml,4级骨转移组1.10±0.22 ng/ml,β-CTx随骨转移级别增加逐渐升高,仅对照组和1级骨转移组、1级和2级骨转移组间无明显差异(P>0.05),其余各组两两比较均有显著性差异(P<0.01)。骨转移组N-MID水平约18.70 ng/ml,高于对照组14.31ng/ml,但无统计学差异(P>0.05),随骨转移级别增加,N-MID水平有逐渐上升的趋势,但各组间比较无明显差异(P均>0.05)。结论:β-CTx可以应用于骨转移的辅助诊断和2级以上骨转移程度监测,N-MID对肿瘤骨转移的诊断价值和骨转移程度的监测价值不明显。     

磁共振各序列在骨挫伤及骨转移诊断中的应用

目的:探讨磁共振各序列在骨挫伤及骨转移诊断中的应用价值。方法:对商丘市第一人民医院的45例骨挫伤及骨转移患者行磁共振检查,磁共振扫描前经CR或CT扫描。使用GESigna Contour 0.5T超导型扫描机,脊柱扫描使用脊柱线圈,膝关节扫描使用膝关节线圈,行矢状位、冠状位及横断扫描。扫描序列包括各序列。结果:所有45例接受磁共振检查的患者中,骨转移并骨损伤10例,膝关节骨挫伤合并半月板、韧带损伤22例,骨转移并伴有相邻椎体脊髓水肿13例。结论:对于骨挫伤及骨转移脂肪抑制序列T2WI检查好于TSET2WI及FL2DT2WI,与SET1WI相结合能够更敏感的发现骨挫伤及骨转移改变。     

骨髓脂肪在骨质代谢中的作用及其相关机制

随着人的年龄增长,骨髓组织会发生一系列骨生物学和病理生理学的代谢变化,间充质干细胞的成骨/成脂化过程构成骨质代谢的主要部分,骨髓组织为间充质干细胞和造血干细胞的分化成熟提供独特的生长环境。骨髓脂肪细胞异常增多是导致骨质疏松等疾病的重要因素之一,诸多细胞因子、激素分子通过复杂的信号通路网络作用于这个过程。就骨髓脂肪在骨质代谢中发挥的作用及其可能的发生机制予以综述。     

骨扫描与肿瘤标志物联检在骨转移诊断中的应用进展

骨骼是晚期恶性肿瘤最常见的扩散转移部位之一.由骨转移引发的骨相关事件可以明显影响晚期肿瘤病人的生活质量和临床转归.骨扫描目前仍然是诊断骨转移的首选检查方法.尽管骨扫描具有高度的敏感性,但其特异性仍较低,如与不同癌症的相关肿瘤标志物联检,可明显提高骨扫描的诊断特异性,还可不同程度地提高其诊断的敏感性和准确性.就骨扫描与肿瘤标志物联检在骨转移诊断中的应用及其潜在的临床价值予以综述.     

CT of the temporal bone in achondroplasia

In an attempt to better define the changes affecting the temporal bone that might predispose achondroplastic dwarfs to otitis media, nine achondroplastic subjects who were evaluated for hearing loss underwent high-resolution CT scanning of the temporal bone. Comparisons were made with 10 nonachondroplastic subjects. A number of morphologic changes were seen, including (1) poor development of mastoid air cells, (2) foreshortening of the carotid canals, (3) narrowing of the skull base, (4) "towering" petrous ridges, and (5) relative "rotation" of the cochlea and other temporal bone structures. The most significant change was the rotational effect, which was more pronounced medially, resulting in an abnormal orientation of inner ear structures relative to middle ear structures and of middle ear structures relative to the external auditory canal. There was a notable lack of evidence for otitis media or its sequelae in any of the achondroplastic subjects. Audiograms were obtained in six of the nine achondroplastic subjects (two adults and four children). There was evidence of mixed hearing loss in the four children, but only of sensorineural hearing loss in the adults. We believe that the persistent hearing loss in achondroplasia is not due to sequelae of otitis media as some authors have suggested. Intrinsic vestibulocochlear changes below the limits of resolution of high-resolution CT scanning may be responsible.     

Selective arterial embolization in the treatment of aneurysmal bone cyst and angioma of bone

Nineteen aneurysmal bone cysts and five angiomas of bone were treated by selective arterial embolization. The median follow-up was 22 months. In 17 patients healing occurred with complete relief of symptoms; in 11 of these almost complete ossification of the lesion resulted. In the remaining cases, little or no ossification was apparent but ossification may take 1 year or more to occur. No recurrence was observed in any of these cases. Recurrence occurred only in two cases. In one, growth of the recurrence stopped after a second embolization, and the X-rays showed no change. Selective arterial embolization represents a treatment of choice in aneurysmal bone cyst and angioma of bone especially of the spine, sacrum, or pelvis. In these sites embolization replaces surgery which might be hazardous due to intraoperative bleeding.Supported in part with Rizzoli Research Funds     

MR in the diagnosis of bone tumours

Forty-two patients with benign as well as malignant bone tumours or with tumour-like lesions of bone were evaluated using MR tomography. The appropriate choice of examination parameters is an essential prerequisite for the adequate visualisation and the definitive verification of the presence of a tumour. By means of its multi-planar display, MR provides definite advantages in the determination of tumour localisation and extension as well as in differentiating intra-tumoural haemorrhage from surrounding, non-involved tissue. In addition, the clear delineation of neighbouring structures such as muscular compartments and blood vessels achieved in MR can be useful in the planning of an eventual surgical approach. This new technique has proved itself superior to other available imaging modalities in the differentiation of residual or recurrent tumour from post-operative changes. A characterisation of the nature or histology of a suspicious lesion on the basis of relaxation-times or signal intensities, however, is not yet possible.