MR imaging of simple bone cysts in children: not so simple

Abstract

UBCs frequently appear complicated on MR imaging, with heterogeneous fluid signals and regions of nodular and thick peripheral enhancement related to previous pathologic fracture and early healing.

Fluid-fluid levels in bone neoplasms: variation of T1-weighted signal intensity of the superior to inferior layers—diagnostic significance on magnetic resonance imaging

“…b Axial T2W FSE (TE 160, TR 5,500) image demonstrates that the signal in the superior layer is now high (black arrow and the inferior layer is low (white arrow) Table 2 The prevalence of The presence of the L/H SI pattern on T1W images is significantly contributed to by lesions that are primary ABC (n=24/50) or contain secondary ABC change (21/50). Secondary ABC formation can occur in SBC [23], fibrous dysplasia [21], GCT [1,18], osteosarcoma, may be relatively frequent in chondroblastoma (4/5 cases [11]),and rarely in clear cell chondrosarcoma [42]. Such lesions are relatively frequent in this group: SBC, n=4; chondroblastoma, n=6; GCT, n=5; osteosarcoma, n=6.…”

“…In our study, the appearance of the H/L FFLs on T1W MRI may reflect the early stage at which haemorrhage can be identified in both benign and malignant disease. A number of benign lesions are predisposed to acute haemorrhage (GCT, SBC, primary and secondary ABC) [1,44,23], some can be related to trauma and healing such as in SBC [23]. Certainly in our group there was a large number of ABCs (n=13/52), GCTs (n=8/52), metastasis (n=4/52: two renal, one bronchial, one adenocarcinoma) and osteosarcomas (n=14/52) that may have contributed in particular to the large proportion of this finding in this group.…”

“…Benign lesions that demonstrate FFLs include chondroblastoma [10][11][12][13][14], giant cell tumour (GCT) [14][15][16][17][18], cystic fibrous dysplasia [1,14,[19][20][21][22], simple bone cyst (SBC) [1,4,14,23,24], intraosseous ganglion [25], osteomyelitis [5,14], osteoblastoma [26,27], Langerhans' cell histiocytosis (LCH) [28,29], ossifying fibroma [30], intraosseous lipoma [14], enchondroma [14], brown tumour [31,32] and fibroxanthoma [21,33]. Malignant tumours that demonstrate FFLs include telangiectatic osteosarcoma [3,6,14,34,35], conventional osteosarcoma [1,14], osteosarcoma post-chemotherapy [6], malignant fibrous histocytoma (MFH)/fibrosarcoma [1,14,36], plasmacytoma [37], meta...…”

“…The pathological causes of FFLs, the pathological tissue in the superior and inferior layer and the corresponding SI appearances of the superior and inferior layers on T1W and T2W FSE/STIR imaging Can occur in hypervascular lesions or those predisposed to haemorrhage, such as ABC[33], trauma in ABC, complicated SBC[23,44] or fibrous dysplasia Malignant lesions[1,44] can have more acute haemorrhage, be related to necrosis or neovascularisation c Can have haemorrhage superimposed…”

Tumors and Tumor-Like Conditions of Bone

“…Fatty change may be seen within the cyst and is most often encountered in the calcaneus [ 13 ]. Especially after prior fracture, unicameral bone cysts may be multiloculated and demonstrate heterogeneous signal, nodular enhancement, and fl uid-fl uid levels [ 22 ].…”