Osteoid osteoma--the CT vessel sign.

Abstract

To evaluate whether the presence of a feeding vessel in proximity to osteoid osteomas of long bones on multidetector CT (MDCT) can be an adjuvant clue for the diagnosis of osteoid osteoma. Forty-nine CT scans of patients with radiological and clinical diagnosis of osteoid osteoma of long bones and a control group of 20 CT scans of patients with cortical-based lesions other then osteoid osteoma were analyzed. Two radiologists evaluated the CT images in consensus for the presence of a blood vessel in the same axial slices in which the nidus of osteoid osteoma was seen and to determine the incidence. In 39 cases (79.6%) of osteoid osteoma, a blood vessel either entered the nidus (23 patients) or was seen in proximity to it (16 patients). This was significantly different (P < 0.05) from the cortical-based lesions, in which only two CT scans (10%) showed a blood vessel in the lesion's proximity. In the majority of osteoid osteoma lesions in long bones, a blood vessel can be seen on MDCT either entering the nidus itself or in its proximity. The role of this vessel in the lesion pathogenesis and whether it improves diagnostic accuracy need further evaluation.