Clinical, imaging characteristics of benign and aggressive spinal osteoblastoma / 中华放射学杂志

ABSTRACT

Objective To investigate the clinical and imaging manifestations of benign and aggressive spinal osteoblastoma. Methods Seventeen patients with benign osteoblastoma (BO) and 18 patients with aggressive osteoblastoma(AO) from May 2004 to November 2015 diagnosed by orthopedic doctor and pathologist were analyzed retrospectively. Thirty four patients (17 BO, 17 AO ) underwent CT plain scanning, 26 patients underwent MRI. The follow-up time was 6 to 96 months, the postoperative recurrence rate was calculated. The continuous variables including the age, the duration of symptoms and the size of tumor were compared between AO and BO with the 2-tailed Student t test or Mann-Whitney U test. The categorical variables were compared between AO and BO with χ2test.A P value<0.05 was considered statistically significant. Results The age was significantly different between AO and BO [(29.82 ± 14.69) Y vs (19.76 ± 10.33)Y, P<0.05]. The duration of symptoms was significantly different between AO and BO [15(6,96)m vs 6(1,60)m, P<0.05].The size of tumor was significantly different between AO and BO [(4.01 ± 1.46) cm vs (2.08 ± 0.64) cm, P<0.05]. Neurological deficit was found in 2 patients with BO and 9 patients with AO, there was significant difference(P<0.05).In the BO group,the adjacent bone involved(n=3),the calcification of the lesion(n=17),intact bony cortex(n=17),the ill-defined sclerotic bone around the lesion(n=17),the edema of bone marrow and adjacent soft tissue around the lesion (n=11), and intense enhancement (n=2) were observed in BO. While in the AO group, there were 11 patients with adjacent bone involved. The calcification of the lesion (n=12),intact bony cortex(n=0), the ill-defined sclerotic bone around the lesion(n=11),the edema of bone marrow and adjacent soft tissue around the lesion(n=10), and intense enhancement (n=10) were observed in AO. The above imaging features of BO were significantly different from that of AO(P all<0.05).The sex distribution,the location of the lesion,preoperative ALP,the type of bone destruction,the signal intensity were not significantly different between BO and AO(P>0.05).The recurrence rate of AO(37.50%)was significantly different from that of BO (6.67%,P=0.04).Conclusion The clinical features including the age,duration of symptoms,neurological deficit contributed to differentiating BO from AO.The size of AO was bigger than BO,and AO didn't have intact bony cortex.In the AO group,there was less calcification in the lesion,less edema of bone marrow and adjacent soft tissue around the lesion.The post-operation recurrence of AO was higher than BO.