[A comparative study between magnetic resonance imaging and histological findings of bone and soft tissue tumors].
Diagnostic methodology for bone and soft tissue tumors has made great strides recently through the development of magnetic resonance imaging (MRI). Here we report a comparative assessment of the histological findings of bone and soft tissue tumors with MRI from 212 cases. The accuracy of a qualitative diagnosis was observed in a solitary bone cyst, enchondroma, giant cell tumor, chondrosarcoma, lipoma, hemangioma, neurinoma, and in a synovial cyst. However, the qualitative diagnosis of a malignant tumor was difficult because of the variety of the intratumoral histological changes. An enhanced-image using Gd-DTPA was useful for differentiation of the viable region in the internal area of a tumor, discrimination of the rective zone of an edema or assessing vascularity, and for discrimination between a cyst and a solid tumor. Based on comparison with findings from the excised specimen, it was found that histological changes such as calcification, fibrosis, hemorrhaging and necrosis, and the presence or absence of a tumor capsule had been reflected accurately on MR images. However, infiltration of the tumor into the bone cortex and into the articular cartilage were found frequently to be false-positive on MRI. Although problems remained to be solved regarding the evaluation of the presence or absence of tumor infiltration into adjacent tissue, the depiction of periosteal reaction, and regarding differentiation from inflammatory disease, MRI was a very useful information source for operative planning because it could evaluate the relationship between the tumor and adjacent blood vessels or nerves, the effect of preoperative therapy, and effectively discriminate between benign and malignant tumors.
Itoh
K
K
Department of Orthopedic Surgery, Tokyo Medical College, Japan.
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012983:Soft Tissue Neoplasms / Q000175:diagnosis* / Q000473:pathology*