· PDF fileWHO 1. conventional OS a osteoblastic type b chondroblastic type c fibroblastic...
Transcript of · PDF fileWHO 1. conventional OS a osteoblastic type b chondroblastic type c fibroblastic...
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1. osteosarcomas
2. chondrosarcoma
3. Ewing sarcoma
4. malignant fibrous histiocytoma
5. myeloma
6. malignant lymphoma of bone
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1.
geographic moth-eaten permeative
2.
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3.
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4.
Codman onion peel sunburst(spiculated)
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5.
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1. central OS
2. parosteal OS
3. periosteal OS
4. high-
grade surface OS
5. extra-osseous OS
6. multifocal OS
1. conventional OS
a osteoblastic type
b chondroblastic type
c fibroblastic type
2. telangiectatic
OS (TOS)
3. low grade
central OS
4. small cell OS
5. undifferentiated
6. secondary
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WHO
1. conventional OS
a osteoblastic type
b chondroblastic type
c fibroblastic type
2. telangiectatic OS (TOS)
3. small cell OS
4. low grade central OS
5. secondary
6. parosteal OS
7. periosteal OS
8. high-grade surface OS
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conventional central OS
1.
2.
50 100 1 ( 130-260 )
15 10 >20 >10 >
2 5
3.
3-4
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10
Sunburst
Codman
21817448
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MRIMRI
T1T1
T2T2
sunburstsunburst
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201Tl
viability
201Tl
Tumor-to-background ratio (TBR) (T)
(B) ROI TBR= T-B)/B
Alteration ratio TBR1
TBR2 alternation ratio(%)=(TBR1-TBR2)/TBR1 100
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grade2
Grade0 50-100%
Grade1 10-50%
Grade2 10
Grade3
2008/9/24
2008/9/5
2008/7/1
2008/7/11
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2006/10/12 2007/11/16
70 Paget OS21549176
Paget
50
OS 50%
MFH25%
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47
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parosteal OS
1.
(surface osteosarcoma)
2.
4% ( : =1:2) 20
30
3.
60%
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50
MRI
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telangiectatic OS
1.
X
(high-grade)
2.
2.6-4.3% : =3:2
3.
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70
21899495
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MRI
T1T2
ABC fluid-fluid
level
ABC
)
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chondrosarcoma
1. conventional CHS
a. primary CHS
b. ( ) periosteal CHS
c. secondary CHS
2. dedifferentiated CHS
3. mesenchymal CHS
4. clear-cell CHS
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chondrosarcoma
1.
2.
11-27%
30-50
3.
45%(
49% 36%) 25 8% 7% 5%
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60
erosion (endostealerosion)
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21727210
MRI
T1 T2
ring and arc
enhancement
endosteal scalloping
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2/3
T1WI
entraped fat entraped fat ( )
T2WI - - -
CE ring and arc ring and arc ring and arc
+
Yoo HJ. Eur Radiol 2009
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periosteal CHS
1.
2.
4% 30-40
3.
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40
erosion
Codman
MR
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secondary CHS
1.
2.
5-25
(Ollier ) 30-50
20 50
3.
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50
1.5-2cm1.5-2cm
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Ewing sarcoma
1.
PNET(primitive neuroectodermal tumor)
Ewing
2.
6-10% ( )
10 80%( 13 30 : =3:2
3.
CRP LDH 2/3
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4
Moth-eaten onion peel sunburst
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21886938
MRI
T1
T2
erosion
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malignant fibrous histiocytoma (MFH) of bone
1.
(striform pattern)
MFH 30%
2.
2 20 45 2
40
3.
7-9
30-45
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60
38
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MRIMRI
GCTGCT
21518408
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myeloma
1.
( )
(
) (
) 20
1 M
2.
35 60-70 40
3.
Ca
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60
(punched(punched out)out)
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21761922
MRIMRI
T1T1 T2T2
variegate patternvariegate pattern))
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primary malignant lymphoma of bone1.
9
non-Hodgkin B cell lymphoma
2.
3 20 50
2 40
3.
25
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30
(ivory vertebra )
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MRIMRI
T1T2T1T2
21440260
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1. osteosarcomas
2. chondrosarcoma
3. Ewing sarcoma
4. malignant fibrous histiocytoma
5. myeloma
6. malignant lymphoma of bone