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Analysis of magnetic resonance imaging findings and clinicopathologic features of sacrococcygeal chordoma
FANG Han-zhen  HU Mei-yu  PAN Bi-tao  Pan Xi-min  LAI Ying-rong  JIANG Bo 

DOI:10.12015/issn.1674-8034.2017.11.010.


[Abstract] Objective: To assess the conventional MRI and dynamic contrast-enhanced MRI (DCE-MRI) features of sacrococcygeal chordoma and their pathological basis.Materials and Methods: The appearances of both conventional MRI and DCE-MRI were observed in 21 patients with sacrococcygeal chordoma as well as the HE-stain pathologic manifestations. The maximal dimension of tumoral mass (MDTS) was measured and the DCE-MRI indexes were acquired of time signal intensity curve (TSIC), wash in rate (WiR), wash out rate (WoR) and time to peak (TTP) in the 21 patients.Results: The tumoral mass was characterized by the hyper-intensity on T2-weighted images. The MDTS of 18 patients with positive "pod-like margin" sign were larger than those of the 3 patients with negative one (t=2.800, P=0.011). The gradual and sustained enhancement occurred during the post-contrast 30 minutes in the chordoma mass with TSIC of slow-rising type, WiR at 0.75±0.05, WoR at 0, and TTP at 30.00 minutes. Pathologically, the prominent finding was tumoral cell nets rich in vacuolated cells and physaliphores alternating with zones of mucin collection.Conclusion: Sacrococcygeal chordoma possesses the biologic behavior property of vertebral body-centered three-dimensional invasion with a tendency of prevertebral extension, and the "pod-like margin" sign comprises its marginal morphological feature. The characteristic hyper-intensity on T2-weighted image, and the occurrence of gradual and sustained enhancement are closely related to tumoral cells and mucin within tumoral mesenchyma.
[Keywords] Chordoma；Sacrum；Coccyx；Magnetic resonance imaging

FANG Han-zhen Department of Radiology, Huilai County People's Hospital, Jieyang 515200, China

HU Mei-yu Department of Radiology, East Hospital, Sun Yat Sen University First Affiliated Hospital, Guangzhou 510700, China

PAN Bi-tao Department of Clinical Diagnostic Radiology, Sun Yat Sen University First Affiliated Hospital, Guangzhou 510080, China

Pan Xi-min Department of Radiology, East Hospital, Sun Yat Sen University First Affiliated Hospital, Guangzhou 510700, China

LAI Ying-rong Department of Pathology, Sun Yat Sen University First Affiliated Hospital, Guangzhou 510080, China

JIANG Bo* Department of Clinical Diagnostic Radiology, Sun Yat Sen University First Affiliated Hospital, Guangzhou 510080, China

*Correspondence to: Jiang B, E-mail: csujbo@163.com

Conflicts of interest   None.

Received  2016-07-31
Accepted  2016-10-19
DOI: 10.12015/issn.1674-8034.2017.11.010
DOI:10.12015/issn.1674-8034.2017.11.010.

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