Primary vertebral osteosarcoma: Imaging findings
Primary vertebral osteosarcoma: Imaging findings
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DOI：
10.1148/radiol.2303030226
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发表时间：
2004-03-01
期刊：
影响因子：
19.7
通讯作者：
Shives, TC
中科院分区：
文献类型：
--
作者：
Ilaslan, H;Sundaram, M;Shives, TC
目得：评价患者的年龄、性别、部位和影像学表现的原发性脊椎骨肉瘤（PVOS）相比，组织学亚型。材料和方法：回顾性分析（1915年至2001年）的影像学表现的患者经组织学证实的原发性脊柱骨肉瘤进行。两位放射科医生一致回顾了位置、起源部位、基质模式和椎管侵犯的结果，并将其与组织学亚型进行了比较。结果：4,887例骨肉瘤中，198例（4%）为脊柱源性PVOS。有103名女性和95名男性患者（年龄范围，8-80岁;中位年龄，34.5岁）。累及包括颈椎（27例患者）、胸椎（66例患者）、腰椎（64例患者）和骶椎（41例患者）。69例患者有足够的影像学表现，12例（17%）累及两个节段。非骶椎肿瘤44例，多发生于椎体后部，部分累及椎体。局限于椎体的病变较少见（12例）。骶骨肿瘤累及骶骨体部和骶骨翼部。最常见的组织学亚型为成骨细胞（47例患者）、成软骨细胞（12例患者）、毛细血管扩张（4例患者）、成纤维细胞（4例患者）、小细胞（1例患者）和上皮样（1例患者）。大多数（55例）显示类骨基质矿化; 17例显示明显矿化。5例明显矿化局限于椎体，呈“象牙椎”样。14例（20%）为松解型。在4例（100%）毛细血管扩张型、3例（75%）成纤维细胞型、3例（25%）成软骨细胞型、3例（6%）传统成骨细胞型和1例（100%）小细胞亚型中观察到溶解模式。椎管侵犯多见（84%）。7例表现为骨母细胞瘤样改变，无软组织肿块。病理性压缩骨折被确定（7例患者）。结论：本研究提供了一个大型系列的PVOS的年龄和性别分布和位置和影像学特征。(C)RSNA，2004年。
PURPOSE: To evaluate patient age and sex and location and imaging appearances of primary vertebral osteosarcoma (PVOS) compared with histologic subtypes.MATERIALS AND METHODS: Retrospective review (1915-2001) of imaging findings in patients with histologically proved primary osteosarcoma of vertebral column was performed. Two radiologists in consensus reviewed findings for location, origin site, matrix pattern, and spinal canal invasion and compared them with histologic subtypes. Radiation-induced, Paget, metastatic, and multifocal osteosarcoma were excluded.RESULTS: Of 4,887 osteosarcoma cases, 198 (4%) were PVOS arising from vertebral column. There were 103 female and 95 male patients (age range, 8-80 years; median age, 34.5 years). Involvement included cervical (27 patients), thoracic (66 patients), lumbar (64 patients), and sacral (41 patients) spine. Adequate imaging findings were available in 69 patients, and involvement of two levels was seen in 12 (17%). In nonsacral spine, most tumors (44 cases) arose from posterior elements, with partial involvement of vertebral body. Lesions confined to vertebral body were less frequent (12 cases). Sacral tumors involved body and sacral ala. The most common histologic subtypes were osteoblastic (47 patients), chondroblastic (12 patients), telangiectatic (four patients), fibroblastic (four patients), small cell (one patient), and epithelioid (one patient). The majority (55 cases) demonstrated osteoid matrix mineralization; 17 showed marked mineralization. Five cases with marked mineralization were confined to vertebral body, with "ivory vertebra" appearance. Purely lytic pattern was seen in 14 (20%) cases. Lytic pattern was seen in four (100%) telangiectatic, three (75%) fibroblastic, three (25%) chondroblastic, three (6%) conventional osteoblastic, and one (100%) small-cell subtypes. Invasion of spinal canal was common (84% of cases). Appearance simulating osteoblastoma without soft-tissue mass was present (seven cases). Pathologic compression fractures were identified (seven patients).CONCLUSION: This study provides age and sex distribution and location and imaging features in a large series of PVOS. (C) RSNA, 2004.