Korean J Radiol.  2014 Feb;15(1):114-122. 10.3348/kjr.2014.15.1.114.

MR Findings of the Osteofibrous Dysplasia

• Jung JY
• Jee WH
• Hong SH
• Kang HS
• Chung HW
• Ryu KN
• Kim JY
• Im SA
• Park JM
• Sung MS
• Lee YS
• Hong SJ
• Jung CK
• Chung YG

• KMID: 1711485
• DOI: http://doi.org/10.3348/kjr.2014.15.1.114

Abstract

OBJECTIVE
The aim of this study was to describe MR findings of osteofibrous dysplasia.
MATERIALS AND METHODS
MR images of 24 pathologically proven osteofibrous dysplasia cases were retrospectively analyzed for a signal intensity of the lesion, presence of intralesional fat signal, internal hypointense band, multilocular appearance, cortical expansion, intramedullary extension, cystic area, cortical breakage and extraosseous extension, abnormal signal from the adjacent bone marrow and soft tissue and patterns of contrast enhancement.
RESULTS
All cases of osteofibrous dysplasia exhibited intermediate signal intensity on T1-weighted images. On T2-weighted images, 20 and 4 cases exhibited heterogeneously intermediate and high signal intensity, respectively. Intralesional fat was identified in 12% of the cases. Internal low-signal bands and multilocular appearance were observed in 91%. Cortical expansion was present in 58%. Intramedullary extension was present in all cases, and an entire intramedullary replacement was observed in 33%. Cortical breakage (n = 3) and extraosseous mass formation (n = 1) were observed in cases with pathologic fractures only. A cystic area was observed in one case. Among 21 cases without a pathologic fracture, abnormal signal intensity in the surrounding bone marrow and adjacent soft tissue was observed in 43% and 48%, respectively. All cases exhibited diffuse contrast enhancement.
CONCLUSION
Osteofibrous dysplasia exhibited diverse imaging features ranging from lesions confined to the cortex to more aggressive lesions with complete intramedullary involvement or perilesional marrow edema.

Keyword

Osteofibrous dysplasia; Bone neoplasms; Magnetic resonance imaging

MeSH Terms

Adipose Tissue/pathology
Adolescent
Adult
Bone Diseases, Developmental/*diagnosis/pathology
Child, Preschool
Female
Humans
Magnetic Resonance Imaging/*methods
Male
Retrospective Studies

Figure

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  Fig. 1 14-year-old boy presented with incidental radiographic abnormality during evaluation of left tibial pain after contusion. A. Lateral radiograph shows well-defined osteolytic lesion (arrows) with thin sclerotic rim and internal septation in anterior cortex of proximal diaphysis of tibia and another smaller satellite lesion (arrowhead) in more distal cortex. B. Sagittal fat-suppressed T2-weighted image also shows main lesion (arrows) and satellite lesions (arrowhead) involving anterior cortex. C, D. Axial T1- and T2-weighted images show that mass (arrows) is mainly intracortical and exhibits intermediate signal intensity. E. On contrast-enhanced T1-weighted image, mass (arrows) exhibits diffuse heterogeneous enhancement.

• 

  Fig. 2 2-year-old boy presented with pain and pretibial swelling. A. Lateral radiograph shows well-defined osteolytic lesion (arrows), with cortical expansion and anterior bowing. Fracture line is visible at middiaphysis (arrowheads). B. Sagittal T1-weighted image shows intermediate signal intensity mass (arrows) with soft tissue edema (arrowheads). C, D. Axial T1- and T2-weighted images show diffuse heterogeneous intermediate signal mass (arrows) replacing entire medullary space. Axial T2-weighted image also shows periosteal reaction with circumferential and pretibial soft tissue edema (arrowheads), presumably related to pathologic fracture. E. On axial contrast-enhanced T1-weighted image, mass exhibits diffuse heterogeneous enhancement with circumferential soft tissue enhancement (arrows).

• 

  Fig. 3 41-year-old woman presented with incidental radiographic abnormality in right tibia during evaluation of tingling sensation in right foot. A. Lateral radiograph shows mix of bubbly osteolytic and sclerotic lesions (arrows) with indistinct borders on anterior tibial cortex. B, C. Coronal T1- and T2-weighted images show heterogeneously intermediate signal lesions (arrows) in diaphysis of right tibia. D. Sagittal fat-suppressed T2-weighted image shows lesion with multifocal nodular hyperintensities (arrows), corresponding to osteolytic foci in radiography. E. Axial T1-weighted image shows heterogeneously intermediate signal in lesion (arrows) replacing entire medullary cavity. F. Axial T2-weighted image also shows heterogeneously intermediate signals of lesion (arrows). G. On axial contrast-enhanced T1-weighted image, mass exhibits heterogeneous enhancement pattern with nodular enhancing foci (arrows). H. Irregular trabeculae (T) of immature bones have osteoblastic rimming (arrows) and are surrounded by fibrous stroma (S) without cytologic atypia (H&E stain, original magnification × 200).

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