Karbhari Aashna, Vijan Antariksh, Janu Amit Kumar, Gulia Ashish, Kulkarni Suyash, Shetty Nitin, Gala Kunal, Panjwani Poonam
Radiodiagnosis and Imaging, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, India.
Department of Radiology, Advanced Centre for Treatment, Research and Education in Cancer and Homi Bhabha National Institute (HBNI), Kharghar, Navi Mumbai, India.
Indian J Orthop. 2024 Jul 3;58(9):1303-1309. doi: 10.1007/s43465-024-01214-3. eCollection 2024 Sep.
To evaluate the multimodality imaging features of chondroblastoma.
Retrospective analysis of imaging features of 52 cases of histopathologically proven chondroblastoma from 2010 to 2022 was performed. Radiographs were evaluated for lesion site, location, morphology, margins, matrix mineralization, cortical breach, periosteal reaction, eccentricity, and subarticular extension. Appearance on T1, T2 weighted and post-contrast T1 was evaluated on MRI, with analysis of peritumoral edema and joint effusion.
Mean patient age was 18 years (10-57 years) with male preponderance ( = 39; = 13). 75% ( = 39) cases involved an unfused skeleton and 25% ( = 13) affected a mature skeleton. Appendicular skeleton was involved in 88.5% ( = 46) cases and axial skeleton was involved in 11.5% ( = 6) cases with all cases involving epiphysis/epiphyseal equivalent. Radiographically, all cases were well-defined geographic osteolytic lesions with a narrow zone of transition, thin sclerotic rim and lobulated [56% ( = 29)] or smooth [44% ( = 23)] margins. Matrix calcification appreciable in 62% ( = 32) cases was 'fluffy/smudgy'. Chondroblastoma appeared isointense (83%, = 43) on T1 MRI with characteristically low signal and hyperintense foci within (67%, = 35) on T2-weighted images and post-contrast enhancement [heterogeneous lobular (88%, = 46) or septal pattern (12%, = 6)] with all barring three lesions showing perilesional edema. None of the cases of chondroblastoma in our study developed metastasis till last follow-up (mean: 71 months).
Chondroblastoma has distinctive imaging appearance and is often unlike majority other cartilaginous benign lesions due to characteristic low T2 signal on MRI and associated exuberant perilesional edema.
评估软骨母细胞瘤的多模态成像特征。
对2010年至2022年52例经组织病理学证实的软骨母细胞瘤的成像特征进行回顾性分析。对X线片评估病变部位、位置、形态、边缘、基质矿化、皮质破坏、骨膜反应、偏心性和关节下扩展情况。在MRI上评估T1加权、T2加权及T1增强后图像表现,分析肿瘤周围水肿和关节积液情况。
患者平均年龄18岁(10 - 57岁),男性居多(n = 39;n = 13)。75%(n = 39)的病例累及未融合骨骼,25%(n = 13)累及成熟骨骼。88.5%(n = 46)的病例累及四肢骨骼,11.5%(n = 6)累及中轴骨骼,所有病例均累及骨骺/类骨骺部位。X线片上,所有病例均为边界清晰的地图样骨质溶解病变,移行带窄,硬化边缘薄,边缘呈分叶状[56%(n = 29)]或光滑[44%(n = 23)]。62%(n = 32)的病例可见基质钙化,呈“蓬松/模糊”状。软骨母细胞瘤在T1加权MRI上呈等信号(83%,n = 43),在T2加权图像上特征性地表现为低信号及内部高信号灶(67%,n = 35),增强后呈不均匀分叶状(88%,n = 46)或分隔样(12%,n = 6)强化,除3个病变外均可见肿瘤周围水肿。在我们的研究中,直至最后随访(平均71个月),所有软骨母细胞瘤病例均未发生转移。
软骨母细胞瘤具有独特的成像表现,由于其在MRI上特征性的低T2信号及相关的明显肿瘤周围水肿,通常与大多数其他软骨性良性病变不同。