Takahashi M, Sato K, Miura T
Department of Orthopaedic Surgery, Nagoya Memorial Hospital, Aichi, Japan.
Nihon Seikeigeka Gakkai Zasshi. 1993 Oct;67(10):881-96.
The authors studied 33 musculoskeletal sarcomas, comparing preoperative MRIs with postoperative pathological evaluations based on JOA criteria. Fifty-one sites were investigated to determine the clinical significance of a low signal intensity line (LSL) on the outer margin of the tumor image. LSLs at different sites were counted as individual cases, since they sometimes showed different characteristics at different sites. An LSL showing a consistent width and no change on either of two time-weighted images (T1-W or T2-W) was evaluated as a strong LSL, and was thought to represent a barrier preventing tumor penetration. In cases showing a strong LSL, resection beyond the line can provide a safety margin, even if defind as a marginal procedure according to the JOA criteria. In cases showing only a faint LSL, a high rate of tumor cell presence was observed external to the line; in such cases the surgical plan must be focused on the attainment of a curative margin.
作者研究了33例肌肉骨骼肉瘤，根据日本矫形外科学会（JOA）标准将术前MRI与术后病理评估进行比较。对51个部位进行了研究，以确定肿瘤图像外缘低信号强度线（LSL）的临床意义。不同部位的LSL被视为独立病例，因为它们在不同部位有时表现出不同特征。在两个时间加权图像（T1-W或T2-W）上显示宽度一致且无变化的LSL被评估为强LSL，被认为代表阻止肿瘤穿透的屏障。在显示强LSL的病例中，即使根据JOA标准定义为边缘性手术，在线外进行切除也可提供安全切缘。在仅显示微弱LSL的病例中，在线外观察到高比例的肿瘤细胞存在；在这种情况下，手术计划必须专注于获得根治性切缘。
