Costelloe Colleen M, Madewell John E
The University of Texas MD Anderson Cancer Center, Department of Musculoskeletal Imaging, Houston, TX.
The University of Texas MD Anderson Cancer Center, Department of Musculoskeletal Imaging, Houston, TX.
Semin Ultrasound CT MR. 2021 Apr;42(2):114-122. doi: 10.1053/j.sult.2020.08.014. Epub 2020 Sep 1.
The radiographic appearance of primary bone tumors is important for initial diagnosis and often augments histopathological analysis. The original grading system relied on the radiographic analysis of the margin of the lesions to determine tumor aggression, which often corresponds with malignant potential. The recently developed, modified Lodwick-Madewell grading system also incorporates the appearance of lesion margins on radiographs but also considers the change in margins on serial radiographs and includes a category for clinically suspected, radiographically occult, aggressive lesions. This article reviews the prior and modified grading systems, and the concepts necessary for proper interpretation of the initial appearance of bone tumors which often determines the radiologist's recommendation for biopsy or follow-up imaging.
原发性骨肿瘤的影像学表现对于初步诊断很重要，并且常常辅助组织病理学分析。最初的分级系统依靠对病变边缘的影像学分析来确定肿瘤的侵袭性，这通常与恶性潜能相关。最近开发的改良Lodwick-Madewell分级系统不仅纳入了X线片上病变边缘的表现，还考虑了系列X线片上边缘的变化，并包括了临床怀疑的、X线隐匿的侵袭性病变类别。本文回顾了之前的分级系统和改良分级系统，以及正确解读骨肿瘤初始表现所需的概念，而这些表现常常决定放射科医生对活检或后续影像学检查的建议。
