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• Clinical Article •
The differential diagnosis between benign and malignant bone tumors
CHEN Hai-song  HAN Yan  GENG Qing  FENG Wei-hua  LIN Ji-zheng 

DOI:10.3969/j.issn.1674-8034.2014.04.011.


[Abstract] Objective: To find out the specific signs of differential diagnosis between benign and malignant bone tumors by comparing study of MR and pathology.Materials and Methods: Review 156 cases of bone tumors that are proved by surgical procedure and pathology, which include 78 cases of benign and malignant bone tumors respectively (borderline and aggressive tumors like giant cell tumor and desmoplastic fibroma are excluded from the study). The MRI signs were compared with pathological results, the different points between malignant and benign tumors were detected. All the 156 cases were performed MR plain scan using T1WI, T2WI, T2WI with fat suppression and DWI sequences. 81 cases were performed MR enhanced scan using T1WI. The occurrence rates of all the signs in benign and malignant bone tumors are analyzed statistically.Results: Abnormal signals inside bone together with solid soft tissue mass around, 98.5% (64/65) were found in malignant bone tumors, 1.5% (1/65) were found in benign bone tumors, the difference between the two was obvious (u=2.98, P<0.01). Lesions with clear margin, 47.6% (39/82) were malignant, 52.4% (43/82) were benign, there was no demonstrated difference between the two (u=1.45, P>0.05). DWI high signal 51.6% (65/126) was found in the malignant, 48.4% (61/126) in the benign, there was no significant difference between the two (u=1.27, P>0.05). Edema around the tumor, 66.7% (60/90) appeared in the malignant, 33.3% (30/90) appeared in the benign, the difference between the two was obvious (u=2.65, P<0.05). Radial periosteal reaction and Codman triangle: 93.8% (45/48) were displayed in malignant, 6.2% (3/48) were shown in benign bone tumors, the difference between the two was obvious (u=2.83, P<0.01). Remarkable enhancement 71.0% (49/69) demonstrated in the malignant, 29.0% (20/69) in the benign, significant difference existed between the two (u=2.33, P<0.05).Conclusions: The reliable sign of malignant bone tumors is the abnormal signal inside the bone combined with solid soft tissue mass around the bone. Radial periosteal reaction and Codman triangle strongly suggest malignant, and can rarely be seen in benign lesions. Clear margin, DWI high signal and edema have no remarkable value to differentiate the benign and malignant bone tumors. Most of the bone tumors with marked enhancement are malignant.
[Keywords] Bone neoplasms；Magnetic resonance imaging；Diagnosis, differential

CHEN Hai-song Department of Radiology, Affiliated hospital of Medical College, Qingdao University, Qingdao 266003, China

HAN Yan Department of Radiology, Affiliated hospital of Medical College, Qingdao University, Qingdao 266003, China

GENG Qing Department of Radiology, Affiliated hospital of Medical College, Qingdao University, Qingdao 266003, China

FENG Wei-hua Department of Radiology, Affiliated hospital of Medical College, Qingdao University, Qingdao 266003, China

LIN Ji-zheng* Department of Radiology, Affiliated hospital of Medical College, Qingdao University, Qingdao 266003, China

*Correspondence to: Lin JZ, E-mail: 1021540101@qq.com

Conflicts of interest   None.

Received  2014-01-19
Accepted  2014-04-15
DOI: 10.3969/j.issn.1674-8034.2014.04.011
DOI:10.3969/j.issn.1674-8034.2014.04.011.

[1]
Rajiah P, Ilaslan H, Sundaram M. Imaging of primary malignant bone tumors (nonhematological). Radiol Clin North Am, 2011, 49(6): 1135-1161.
[2]
Boulet B, Caramella C, Couanet D, et al. MR imaging patterns of bone marrow. J Radiol, 2010, 91(9): 935-949.
[3]
Hwang S. Imaging of lymphoma of the musculoskeletal system. Magn Reson Imaging Clin N Am, 2010, 18(1): 75-93.
[4]
Daniel A Jr, Ullah E, Wahab S, et al. Relevance of MRI in prediction of malignancy of musculoskeletal system: a prospective evaluation. BMC Musculoskelet Disord, 2009, 10(10): 125.
[5]
Ginat DT, Mangla R, Yeaney G, et al. Diffusion-weighted imaging for differentiating benign from malignant skull lesions and correlation with cell density. AJR Am J Roentgenol, 2012, 198(6): 597-601.
[6]
Costa FM, Canella C, Gasparetto E. Advanced magnetic resonance imaging techniques in the evaluation of musculoskeletal tumors. Radiol Clin North Am, 2011,49(6): 1325-1358.
[7]
徐文坚,陈海松.重视骨关节系统MRI新技术的应用与研究.磁共振成像, 2012, 3(4): 241-244.
[8]
陈应明,孟悛非,江波,等.骨肉瘤骨膜异常的影像表现与病理研究.中华放射学杂志, 2008, 42(3): 247-252.
[9]
Bloem JL, Reidsma II. Bone and soft tissue tumors of hip and pelvis. Eur J Radiol, 2012, 81(12): 3793-3801.
[10]
Fayad LM, Mugera C, Soldatos T, et al. Technical innovation in dynamic contrast enhanced magnetic resonance imaging of musculoskeletal tumors: an MR angiographic sequence using a sparse k-space sampling strategy. Skeletal Radiol, 2013, 42(7): 993-1000.

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