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Multifocal vascular lesions of bone: imaging characteristics
L M Lomasney1, S Martinez, T C Demos
1Department of Radiology, Loyola University Medical Center, Maywood, IL 60153, USA.
Skeletal Radiology
|April 1, 1996
Summary
Plain radiographs are key for diagnosing multifocal bone vascular lesions. While MRI detects more lesions, plain X-rays effectively show aggressiveness and distribution, aiding diagnosis of these rare endothelial tumors.
Area of Science:
- Orthopedics
- Radiology
- Oncology
Background:
- Multifocal bone vascular processes are a diverse group of diseases.
- Four specific entities—cystic angiomatosis, multifocal hemangioma, hemangioendothelioma, and angiosarcoma—originate from endothelial precursors and present with similar radiographic features.
Observation:
- A review of eight cases and literature explored the imaging patterns of these four conditions.
- Plain radiographs revealed radiolucent defects with variable margins, indicating lesion aggressiveness.
- Computed tomography (CT) offered supportive but not definitive diagnostic information.
Findings:
- Radionuclide bone scintigraphy underestimated skeletal involvement in all reviewed cases.
- Radionuclide imaging with labeled red blood cells provided no additional diagnostic information in this series.
- Magnetic resonance imaging (MRI) demonstrated the highest sensitivity in lesion detection, though findings were not pathognomonic.
Implications:
- Plain radiographs are the primary imaging modality for multifocal endothelial bone processes, revealing lesion characteristics and distribution.
- CT provides comparable information to plain radiographs.
- MRI is valuable for detecting additional lesions, while radionuclide scintigraphy shows surprising insensitivity for these vascular tumors.