Department of Orthopaedic Oncology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan.
JBJS Rev. 2020 Mar;8(3):e0077. doi: 10.2106/JBJS.RVW.19.00077.
Despite the evolution in imaging, especially the introduction of advanced imaging technologies, radiographs still are the key for the initial assessment of a bone tumor. Important aspects to be considered in radiographs are the location, shape and size or volume, margins, periosteal reaction, and internal mineralization of the tumor's matrix; careful evaluation of these may provide for accurate diagnosis in >80% of cases. Computed tomography and magnetic resonance imaging are often diagnostic for lesions with typical findings such as the nidus of osteoid osteoma and bone destruction such as in Ewing sarcoma and lymphoma that may be difficult to detect with radiographs; they may also be used for surgical planning. Magnetic resonance imaging accurately determines the intraosseous extent and articular and vascular involvement by the tumor. This article summarizes the diagnostic accuracy of imaging analyses in bone tumors and emphasizes the specific radiographic findings for optimal radiographic diagnosis of the patients with these tumors.
尽管影像学技术不断发展，尤其是先进的影像学技术的引入，放射学检查仍然是骨肿瘤初始评估的关键。放射学检查中需要考虑的重要方面包括肿瘤的位置、形状和大小或体积、边缘、骨膜反应和肿瘤基质的内部矿化；仔细评估这些方面可以在 >80%的病例中提供准确的诊断。对于具有典型表现的病变，如骨样骨瘤的核和 Ewing 肉瘤和淋巴瘤等导致的骨破坏，计算机断层扫描和磁共振成像通常具有诊断价值，这些病变在放射学检查中可能难以发现；它们也可用于手术规划。磁共振成像能准确确定肿瘤在骨髓内的范围以及关节和血管受累情况。本文总结了影像学分析在骨肿瘤诊断中的准确性，并强调了特定的放射学表现，以优化这些肿瘤患者的放射学诊断。
