Department of Orthopedics, Radboud University Medical Center; Nijmegen.
Department of Radiology, Radboud University Medical Center, Nijmegen;
Acta Orthop. 2020 Aug;91(4):471-478. doi: 10.1080/17453674.2020.1763717. Epub 2020 May 20.
Background and purpose - Adequate staging of chondroid tumors at diagnosis is important as it determines both treatment and outcome. This systematic review provides an overview of MRI criteria used to differentiate between atypical cartilaginous tumors (ACT) and high-grade chondrosarcoma (HGCS).Patients and methods - For this systematic review PubMed and Embase were searched, from inception of the databases to July 12, 2018. All original articles describing MRI characteristics of pathologically proven primary central chondrosarcoma and ACT were included. A quality appraisal of the included papers was performed. Data on MRI characteristics and histological grade were extracted by 2 reviewers. Meta-analysis was performed if possible. The study is registered with PROSPERO, CRD42018067959.Results - Our search identified 2,132 unique records, of which 14 studies were included. 239 ACT and 140 HGCS were identified. The quality assessment showed great variability in consensus criteria used for both pathologic and radiologic diagnosis. Due to substantial heterogeneity we refrained from pooling the results in a meta-analysis and reported non-statistical syntheses. Loss of entrapped fatty marrow, cortical breakthrough, and extraosseous soft tissue expansion appeared to be present more often in HGCS compared with ACT.Interpretation - This systematic review provides an overview of MRI characteristics used to differentiate between ACT and HGCS. Future studies are needed to develop and assess more reliable imaging methods and/or features to differentiate ACT from HGCS.
背景与目的——在诊断时充分分期软骨瘤非常重要，因为它决定了治疗和预后。本系统综述提供了用于区分非典型软骨肿瘤（ACT）和高级别软骨肉瘤（HGCS）的 MRI 标准概述。
患者与方法——为了进行这项系统综述，我们检索了 PubMed 和 Embase 数据库，检索时间从数据库建立到 2018 年 7 月 12 日。所有描述经病理证实的原发性中枢性软骨肉瘤和 ACT 的 MRI 特征的原始文章都被纳入。对纳入的论文进行了质量评估。由 2 名评审员提取 MRI 特征和组织学分级的数据。如果可能，进行荟萃分析。该研究已在 PROSPERO 注册，CRD42018067959。
结果——我们的搜索共确定了 2132 条独特的记录，其中有 14 项研究被纳入。共确定了 239 例 ACT 和 140 例 HGCS。质量评估显示，病理和放射学诊断中使用的共识标准存在很大差异。由于存在很大的异质性，我们没有将结果进行汇总分析，并报告了非统计学综合结果。与 ACT 相比，HGCS 中更常出现失陷的脂肪骨髓、皮质突破和骨外软组织扩张。
结论——本系统综述提供了用于区分 ACT 和 HGCS 的 MRI 特征概述。未来需要进一步研究来开发和评估更可靠的成像方法和/或特征，以区分 ACT 和 HGCS。
