Cartilaginous tumors: fast contrast-enhanced MR imaging.
OBJECTIVE
To differentiate between benign and malignant cartilaginous tumors with fast contrast material-enhanced magnetic resonance (MR) imaging.


METHODS
In 37 patients, fast contrast-enhanced MR images were obtained in eight enchondromas, 11 osteochondromas, and 18 chondrosarcomas. Start of enhancement-early, within 10 seconds after arterial enhancement; delayed, between 10 seconds and 2 minutes; late, after 5 minutes on spin-echo images-and progression of enhancement were represented with three types of time-signal intensity curves. Findings were correlated with the surgical specimen in 27 cases, curettage material in three cases, and biopsy combined with long-term follow-up findings in seven cases.


RESULTS
Start of enhancement and the combination of start and progression of enhancement correlated significantly (P <.001) with benign and malignant tumors. Early enhancement was seen in chondrosarcoma, not seen in enchondroma, and seen in osteochondroma only when growth plates were unfused. The sensitivity was 89%, specificity 84%, positive predictive value 84%, and negative predictive value 89%. Differentiation of malignancy from benignity on the basis of early and exponential enhancement was possible with a sensitivity of 61%, specificity 95%, positive predictive value 92%, and negative predictive value 72%.


CONCLUSIONS
Preliminary results show that in the adult population fast contrast-enhanced MR imaging may assist in differentiation between benign and malignant cartilaginous tumors.
Geirnaerdt
M J
MJ
Department of Radiology, Leiden University Medical Center, C2-S, Albinusdreef 2, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
Hogendoorn
P C
PC
Bloem
J L
JL
Taminiau
A H
AH
van der Woude
H J
HJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D002812:Chondroma / Q000175:diagnosis* / Q000473:pathology; D002813:Chondrosarcoma / Q000175:diagnosis* / Q000473:pathology; D003287:Contrast Media; D003475:Curettage; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D006132:Growth Plate / Q000473:pathology; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015831:Osteochondroma / Q000175:diagnosis* / Q000473:pathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors
D003287:Contrast Media; D019786:Gadolinium DTPA