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长骨骨髓内软骨肿瘤的监测

Surveillance of intramedullary cartilage tumours in long bones.

作者信息

Sampath Kumar V, Tyrrell P N M, Singh J, Gregory J, Cribb G L, Cool P

机构信息

Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry SY10 7AG, UK.

出版信息

Bone Joint J. 2016 Nov;98-B(11):1542-1547. doi: 10.1302/0301-620X.98B11.37864.

Abstract

AIMS

The purpose of this study was to determine if clinical and radiological surveillance of cartilage tumours with low biological activity is appropriate.

PATIENTS AND METHODS

A total of 98 patients with an intramedullary cartilage neoplasm in a long bone met our inclusion criteria and were included in the study. These patients had undergone a total of 384 scans. Patients with radiological follow-up of more than three years (46 patients) were divided into two groups: an active group (11 patients) and a latent group (35 patients).

RESULTS

Active lesions had a total growth in all three planes that was > 6 mm, whilst latent lesions had < 6 mm of growth. Most latent lesions were heavily calcified: active lesions were calcified less than 50% (p = 0.025).

CONCLUSION

Clinico-radiological surveillance can identify growing cartilage lesions: MRI is the surveillance modality of choice. A CT scan is recommended, in addition, at presentation to assess the amount of calcification within the lesion. A first follow-up MRI is suggested one year from diagnosis. If the total growth in the cartilage lesion is > 6 mm, surgical treatment should be considered. Otherwise, a second surveillance scan can be performed at three years to determine further management. Cite this article: Bone Joint J 2016;98-B:1542-7.

摘要

目的

本研究旨在确定对低生物学活性软骨肿瘤进行临床和影像学监测是否合适。

患者与方法

共有98例长骨骨髓内软骨肿瘤患者符合纳入标准并被纳入研究。这些患者共接受了384次扫描。影像学随访超过三年的患者(46例)被分为两组:活跃组(11例)和潜伏组(35例)。

结果

活跃性病变在所有三个平面上的总生长超过6 mm,而潜伏性病变生长小于6 mm。大多数潜伏性病变钙化严重:活跃性病变钙化程度小于50%(p = 0.025)。

结论

临床影像学监测可识别生长中的软骨病变:MRI是首选的监测方式。此外,建议在初诊时进行CT扫描以评估病变内的钙化量。建议在诊断后一年进行首次随访MRI检查。如果软骨病变的总生长超过6 mm,则应考虑手术治疗。否则,可在三年时进行第二次监测扫描以确定进一步的治疗方案。引用本文:《骨与关节杂志》2016年;98 - B:1542 - 7。

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