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Imaging of Osteoid Osteoma with Dynamic Gadolinium-enhanced MR Imaging¹

¹ From the Departments of Radiology (P.T.L., F.S.C., C.C.R., C.J.S.) and Orthopedic Surgery (C.P.B.), Mayo Clinic Scottsdale, 13400 E Shea Blvd, Scottsdale, AZ 85259; and Radiology Medical Group of Napa, Calif (C.J.S.). From the 2001 RSNA scientific assembly. Received February 18, 2002; revision requested April 22; final revision received October 14; accepted November 6. Address correspondence to P.T.L. (e-mail: liu.patrick@mayo.edu).

PURPOSE: To compare dynamic gadolinium-enhanced T1-weighted magnetic resonance (MR) imaging with nonenhanced T1-weighted and T2-weighted MR imaging and thin-section computed tomography (CT) for the demonstration of osteoid osteomas.

MATERIALS AND METHODS: The images of 11 patients with pathologically proven osteoid osteomas who underwent nonenhanced MR imaging, dynamic gadolinium-enhanced MR imaging, and CT were retrospectively reviewed. Images obtained with all three techniques were scored for conspicuity of the osteoid osteoma relative to the surrounding bone. Time-enhancement curves were generated from signal intensity measurements of these lesions and the adjacent bone marrow. The mean imaging scores of the four techniques were compared, and the statistical significance was calculated by using a linear model with terms for method and patient. Pairwise comparisons were made by using the Tukey-Kramer adjustment for multiple comparisons.

RESULTS: Compared with CT, dynamic gadolinium-enhanced MR imaging demonstrated the osteoid osteoma equally well in eight of 11 patients and with better conspicuity in three of 11 patients, although this difference was not statistically significant (P = .69). The dynamic gadolinium-enhanced MR images demonstrated the osteoid osteomas significantly better than the nonenhanced T1-weighted (P < .001) and T2-weighted (P < .001) MR images. On the dynamic gadolinium-enhanced MR images, nine (82%) of 11 patients had peak enhancement of the osteoid osteoma in the arterial phase with early partial washout, compared with slower, progressive enhancement of the adjacent marrow. This resulted in greatest lesion to marrow contrast material enhancement in the arterial phase. One osteoid osteoma had peak enhancement in the venous phase, and one showed progressive enhancement through all phases to 150 seconds.

CONCLUSION: Osteoid osteomas can be imaged with greater conspicuity by using dynamic gadolinium-enhanced instead of nonenhanced MR imaging and with conspicuity equal to or better than that obtained with thin-section CT.

© RSNA, 2003

Index terms: Computed tomography (CT), comparative studies • Magnetic resonance (MR), contrast enhancement • Osteoma, 45.3122

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