title: Differential CT and MR imaging diagnosis between low- and high-grade malignant vascular tumors of bone.
abstract: OBJECTIVE
  To investigate the CT and MR imaging findings and differential diagnosis of malignant vascular tumors of bone.
  
  
  METHODS
  CT and MR imaging findings of 18 patients with histopathology-proven malignant vascular tumors of bone were examined. Assessed image features included age, sex, location, CT findings, and MR imaging appearances and dynamic contrast-enhanced MR imaging.
  
  
  RESULTS
  The study group comprised 18 cases, of which 7 were categorized as low-grade malignant vascular tumors (LMT), and 11 were categorized as high-grade malignant vascular tumors (HMT). Malignant vascular tumors of bone showed osteolytic lesions with heterogeneous signs and enhancement, and frequently associated with soft tissue masses and peritumorous edema. The mean age of patient was respectively 34.7 years in LMT with 3 patients younger than 20 and 49.9 years in HMT with 3 patients older than 60 years. The mean lesion diameter was 3.6 cm (range 2-7.2) in LMT with two lesions <3 cm and 7.1 cm (range 3-13) in HMT with 3 lesions greater than 10 cm. LMT showed multifocal (57.1 %) and well-defined (71.5 %) lesions with residual bone (57.1 %), peripheral sclerosis (85.7 %), and slightly hetergeneous enhancement (71.4 %), compared to those of HMT with 9.1, 45.5, 27.3, and 72.7 %, and 9.1 % respectively. Also, HMT appeared as expansive (54.5 %), ill-defined (54.5 %), macroscopic necrosis/cystic (81.8 %) or hemorrhagic (27.3 %) lesion with pathological fracture (27.3 %), and often presented with obviously hetergeneous enhancement (81.8 %), compared to those of LMT with 42.9, 28.6, 42.9, 0, 14.3 and 14.3 % respectively.
  
  
  CONCLUSIONS
  There are some differences in the imaging features between LMT and HMT, while unifocal/multifocal, expansive, ill-defined, necrosis/cystic, hemorrhagic features with age, lesion diameter, peripheral sclerosis, residual bone tissue, pathological fracture and slightly/obviously hetergeneous enhancement highly suggest their differential diagnosis.
authors: Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, 310009 Zhejiang China.
authors: Jian-Xia
authors: JX
authors: Xu
authors: Department of Radiology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, No. 1017 Dongmen North Road, Shenzhen, 518020 Guangdong China.
authors: Li
authors: L
authors: Yang
authors: Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, 310009 Zhejiang China.
authors: Ying
authors: Y
authors: Chen
authors: Zhejiang University School of Medicine, No. 866 Yuhangtang Road, Hangzhou, 310058 Zhejiang China.
authors: Mohamad Wasil
authors: MW
authors: Peeroo
authors: Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, 310009 Zhejiang China.
authors: Xiu-Liang
authors: XL
authors: Zhu
authors: Department of Pathology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, 310009 Zhejiang China.
authors: Yan-Biao
authors: YB
authors: Fu
authors: Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou, 310009 Zhejiang China.
authors: Ri-Sheng
authors: 0000-0002-2428-0268
authors: RS
authors: Yu
keywords: CT; Differential diagnosis; High-grade; Low-grade; MR imaging; Malignant vascular tumors of bone