Magnetic resonance imaging of cartilaginous tumors: a retrospective study of 79 patients |
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| Institution: | 1. Department of Radiology, University Hospital Antwerp, Wilrijkstraat 10, B-2650 Edegem, Antwerp, Belgium;2. Department of Orthopedic Surgery Hospital Antwerp, Wilrijkstraat 10, B-2650 Edegem, Antwerp, Belgium;1. Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania;2. Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania;1. Department of Orthopaedic Surgery, The Affiliated Hospital of Logistics College of Chinese People’s Armed Police Force, Hedong District, Tianjin 300162, P. R. China;2. Department of Orthopaedic Surgery, The General Hospital of Tianjin Medical University, Heping District, Tianjin 300052, P. R. China;3. Department of Nephropathy, The Affiliated Hospital of Logistics College of Chinese People’s Armed Police Force, Hedong District, Tianjin 300162, P. R. China;4. Department of Immunology, Tianjin Key Laboratory of Cellular and Molecular Immunology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China;5. Department of Orthopaedic Surgery, The General Hospital of Chinese People’s Armed Police Force, Haidian District, Beijing 100039, P. R. China;6. Department of Orthopaedic Surgery, Tianjin Hospital, No 406 Jiefang Nan Road, Hexi District, Tianjin 300211, P. R. China;1. Department of Orthopaedic Surgery, Campbell Clinic, University of Tennessee Health Science Center, 1400 South Germantown Road, Germantown, TN 38138, USA;2. Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University Hospital, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107, USA;1. Department of Radiology, Research Institute of Radiological Science, YUHS-KRIBB Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, South Korea;2. Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, South Korea;3. Department of Pathology, Severance Hospital, Yonsei University of College of Medicine, South Korea;4. Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, South korea |
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| Abstract: | Objective: Hyaline cartilaginous tumors are characterized by extremely high signal intensity on T2-weighted images. Recently, some distinctive MR features of cartilaginous bone tumors were reported in small series. Low signal intensity septa surrounding high signal intensity cartilage lobules were seen on T2-weighted images in low-grade chondrosarcomas. On spin-echo T1-weighted images after Gd contrast injection, marked ‘septal’ or ‘ring-and-arc’ enhancement was observed in low-grade chondrosarcomas and enchondromas. The purpose of this study was to determine sensitivity and specificity of these MR findings in diagnosis of cartilaginous tumors, and to assess the value of MR in diagnostic workup of these lesions. Materials and methods: Retrospective evaluation of MR findings in 79 cartilaginous tumors and in 79 non-cartilaginous tumors. All lesions were biopsy proven. Each MR examination was independently reviewed by two experienced radiologists without knowledge of clinical data, radiographic and/or CT findings, or histological diagnosis. All lesions were evaluated for morphology (lobular or non-lobular), presence of a high signal intensity mass on T2-weighted images, presence of low signal intensity septa separating high signal intensity lobules on T2-weighted images, and evidence of septal (‘ring-and-arc’) enhancement.Results: None of the reviewed parameters is useful in diagnosing osteochondromas. Since osteochondromas have a characteristic appearance on plain radiography, the value of MR imaging in the workup of these lesions remains limited. MR findings in enchondromas have a low specificity and a low sensitivity. Low-grade chondrosarcomas, often hard to diagnose on plain radiography and difficult to differentiate from enchondromas, are characterized by the MR tandem of ‘low signal intensity septa on T2-weighted images’ together with ‘septal or ring-and-arc enhancement’ (sensitivity 92.3%, specificity 76.5%). High-grade chondrosarcomas are easily recognized on plain radiography. Conclusions: In differentiating cartilaginous from non-cartilaginous tumors, MR features are highly specific but lack sensitivity. Grading potentials of MR parameters are promising due to the high accuracy in diagnosing low-grade chondrosarcomas. |
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