CT of Sclerotic Bone Lesions: Imaging Features Differentiating Tuberous Sclerosis Complex with Lymphangioleiomyomatosis from Sporadic Lymphangioleiomymatosis

被引：45
作者：
Avila, Nilo A. [1 ,2 ]
Dwyer, Andrew J. [2 ]
Rabel, Antoinette [3 ]
Darling, Thomas [4 ]
Hong, Chien-Hui [5 ]
Moss, Joel [3 ]
机构：
[1] Washington DC Vet Affairs Med Ctr, Serv Radiol, Washington, DC 20422 USA
[2] NIH, Warren G Magnuson Clin Ctr, Bethesda, MD 20892 USA
[3] NHLBI, Translat Med Branch, NIH, Bethesda, MD 20892 USA
[4] Uniformed Serv Univ Hlth Sci, Dept Dermatol, Bethesda, MD 20814 USA
[5] Tainan Hosp, Dept Hlth, Tainan, Taiwan
来源：
RADIOLOGY | 2010年 / 254卷 / 03期
关键词：
D O I：
10.1148/radiol.09090227
中图分类号：
R8 [特种医学]; R445 [影像诊断学];
学科分类号：
1002 ; 100207 ; 1009 ;
摘要：
Purpose: To determine if sclerotic bone lesions evident at body computed tomography (CT) are of value as a diagnostic criterion of tuberous sclerosis complex (TSC) and in the differentiation of TSC with lymphangioleiomyomatosis (LAM) from sporadic LAM. Materials and Methods: Informed consent was signed by all patients in this HIPAA-compliant study approved by the institutional review board. Retrospective analysis was performed of the body CT studies of 472 patients: 365 with sporadic LAM, 82 with TSC/LAM, and 25 with TSC. The images were reviewed by using a picture archiving and communication system workstation with bone settings (window width, 1500 HU; window level, 300 HU) and fit-to-screen option. CT image characteristics assessed included shape, size, and distribution of sclerotic bone lesions with subsequent calculation of differences in the frequency of these lesions. Results: Most commonly the sclerotic bone lesions were round, measured 0.3 cm (range, 0.2-3.2), and were distributed throughout the spine. The frequencies differed among the three patient groups Four or more sclerotic bone lesions were detected in all 25 (100%) of those with TSC, with a sensitivity of .89 (72 of 82) and specificity of .97 (355 of 367) in the differentiation of sporadic LAM from TSC/LAM (P<.01). Conclusion: The number of sclerotic bone lesions at body CT is of potential value in the diagnosis of TSC and in the differentiation of patients with sporadic LAM from those with TSC/LAM. (C)RSNA, 2010
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页码：851 / 857
页数：7
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