Tsukamoto Shinji, Mavrogenis Andreas F, Langevelde Kirsten van, Vucht Niels van, Kido Akira, Errani Costantino
Department of Orthopaedic Surgery, Nara Medical University, Nara, Japan.
First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
Curr Med Imaging. 2022;18(2):142-161. doi: 10.2174/1573405617666210301110446.
Age, location of the tumor, and detailed patient history can narrow the differential diagnosis of spinal bone lesions, including metastasis and primary benign and malignant bone tumors. Computed tomography and magnetic resonance imaging are both crucial in evaluating the characteristics of spinal bone tumors. Growth speed and Lodwick margin description can differentiate malignant from benign tumors to a certain degree. Positron emission tomography has a limited ability to differentiate malignant from benign tumors. A biopsy is often required for a definitive diagnosis. To select the optimal treatment for spinal metastasis, neurological status by epidural spinal cord compression grade (axial T2-weighted magnetic resonance image), radiosensitivity of tumor histology, mechanical instability by Spine Instability Neoplastic Score (sagittal and axial computed tomography image), and systemic disease should be evaluated by a multidisciplinary team. This review article summarizes the role of imaging for diagnosis and treatment of spinal bone tumors.
年龄、肿瘤位置及详细的患者病史可缩小脊柱骨病变的鉴别诊断范围，包括转移瘤以及原发性良性和恶性骨肿瘤。计算机断层扫描和磁共振成像在评估脊柱骨肿瘤特征方面都至关重要。生长速度和洛德维克边缘描述在一定程度上可区分恶性肿瘤和良性肿瘤。正电子发射断层扫描区分恶性肿瘤和良性肿瘤的能力有限。明确诊断通常需要进行活检。为选择脊柱转移瘤的最佳治疗方法，多学科团队应通过硬膜外脊髓压迫分级（轴位T2加权磁共振图像）评估神经状态、通过肿瘤组织学评估放射敏感性、通过脊柱不稳定肿瘤评分（矢状位和轴位计算机断层扫描图像）评估机械性不稳定以及评估全身疾病。本文综述总结了影像学在脊柱骨肿瘤诊断和治疗中的作用。
