Usefulness of radiography in differentiating enchondroma from central grade I chondrosarcoma

被引:114
作者
Geirnaerdt, MJA
Hermans, J
Bloem, JL
Kroon, HM
Pope, TL
Taminiau, AHM
Hogendoorn, PCW
机构
[1] LEIDEN UNIV,MED CTR,DEPT MED STAT,NL-2300 RC LEIDEN,NETHERLANDS
[2] WAKE FOREST UNIV,BOWMAN GRAY SCH MED,DEPT RADIOL,WINSTON SALEM,NC 27157
[3] LEIDEN UNIV,MED CTR,DEPT ORTHOPAED,NL-2300 RC LEIDEN,NETHERLANDS
[4] LEIDEN UNIV,MED CTR,DEPT PATHOL,NL-2300 RC LEIDEN,NETHERLANDS
关键词
D O I
10.2214/ajr.169.4.9308471
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
OBJECTIVE. The purpose of this study was to evaluate clinical symptoms and radiographic features that allow radiologists to differentiate between enchondroma and central grade 1 chondrosarcoma Such differentiation is important because of differences in management. MATERIALS AND METHODS. Clinical symptoms and location and size of 35 enchondromas and 43 central grade 1 chondrosarcomas were analyzed. Radiographic features were assessed independently by three observers. The chi-square test and linear discriminant analysis were used to identify features with discriminating strength. Kappa values were calculated to validate the consistency of observations among observers. A consensus diagnosis made by histology and long-term follow-up was used as the standard. RESULTS. No statistically significant correlation was found between clinical symptoms and the benign or malignant nature of the neoplasms. Grade 1 chondrosarcomas were more likely to be found in the axial skeleton and in flat bones. Also, chondrosarcomas were significantly larger than enchondromas (p < .001). Ill-defined margins and lobulated contours were the only morphologic features seen on radiographs that allowed significant discrimination (p = .004 and .009, respectively). An optimal combination of four radiographic features still left 72 of the 78 lesions with a 10-90% probability of malignancy, indicative of poor discriminating power. Kappa values generally showed poor to fair agreement. CONCLUSION. Location in the axial skeleton and size greater than 5 cm are the most reliable predictors of central grade 1 chondrosarcoma. Morphologic features seen on radiographs and clinical symptoms do not improve the ability to differentiate between enchondromas and central grade 1 chondrosarcomas.
引用
收藏
页码:1097 / 1104
页数:8
相关论文
共 34 条
[1]   MR OF ENCHONDROMA AND CHONDROSARCOMA - RINGS AND ARCS OF GD-DTPA ENHANCEMENT [J].
AOKI, J ;
SONE, S ;
FUJIOKA, F ;
TERAYAMA, K ;
ISHII, K ;
KARAKIDA, O ;
IMAI, S ;
SAKAI, F ;
IMAI, Y .
JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 1991, 15 (06) :1011-1016
[2]  
CAMPANACCI M, 1990, BONE SOFT TISSUE TUM, P267
[3]  
CAMPANACCI M, 1990, BONE SOFT TISSUE TUM, P213
[4]   HYALINE CARTILAGE - ORIGIN BONE AND SOFT-TISSUE NEOPLASMS - MR APPEARANCE AND HISTOLOGIC CORRELATION [J].
COHEN, EK ;
KRESSEL, HY ;
FRANK, TS ;
FALLON, M ;
BURK, DL ;
DALINKA, MK ;
SCHIEBLER, ML .
RADIOLOGY, 1988, 167 (02) :477-481
[5]  
DeBeuckeleer LHL, 1996, SKELETAL RADIOL, V25, P137
[6]  
DIETLEIN M, 1990, Roentgen-Blaetter, V43, P174
[7]  
ENNEKING WF, 1983, MUSCULOSKELETAL TUMO, P878
[8]  
ENNEKING WF, 1983, MUSCULOSKELETAL TUMO, P939
[9]  
EVANS HL, 1977, CANCER-AM CANCER SOC, V40, P818, DOI 10.1002/1097-0142(197708)40:2<818::AID-CNCR2820400234>3.0.CO
[10]  
2-B