Department of Orthopaedic Surgery, Mayo Clinic Arizona, 5777 E Mayo Boulevard, Phoenix, AZ 85054, USA.
Clin Orthop Relat Res. 2013 Mar;471(3):878-82. doi: 10.1007/s11999-012-2482-5.
Compressive osseointegration is a durable method of method of achieving fixation in long-bone reconstruction, and radiographic findings are well described. The radiographic appearance of integration into the pelvis is poorly defined in the available literature.
We describe a 50-year-old man with a localized chondrosarcoma of the pelvis treated with wide resection and reconstruction using a custom acetabular device that used compressive osseointegration for fixation. A linear area of sclerosis was identified at the patient's 3-month followup surveillance film, which was concerning for tumor recurrence. We used PET-CT to document the absence of worrisome hypermetabolism and to support our suspicion that the abnormalities seen on a surveillance CT scan represented bony integration into the custom acetabular component rather than tumor recurrence.
The use of FDG-PET for staging and surveillance of chondrosarcoma is presently evolving. Several articles suggest it may be useful in differentiating low-grade chondrosarcoma from benign lesions.
We found PET-CT useful to differentiate the midterm radiographic appearance of the remodeling produced by compressive implant osseointegration from local recurrence.
压缩性骨整合是实现长骨重建固定的一种持久方法，其影像学表现已有详细描述。然而，在现有文献中，对骨盆融合的影像学表现描述较少。
我们描述了一位 50 岁男性，患有局部性软骨肉瘤，采用广泛切除和定制髋臼装置重建进行治疗，该装置采用压缩性骨整合进行固定。在患者 3 个月的随访监测影像上发现线性硬化区，这令人担忧，提示肿瘤复发。我们使用 PET-CT 来记录无令人担忧的高代谢，并支持我们的怀疑，即监测 CT 扫描上的异常表现代表骨整合到定制髋臼组件中，而不是肿瘤复发。
目前，FDG-PET 在软骨肉瘤的分期和监测中的应用正在发展。有几篇文章表明，它可能有助于区分低级别软骨肉瘤和良性病变。
我们发现 PET-CT 有助于区分中期由压缩性植入物骨整合引起的重塑的影像学表现和局部复发。
