Differentiation between neoplastic and nonneoplastic conditions magnetic resonance imaging(MRI) has established itself as one of the key clinical tools in evaluation of musculoskeletal pathology. However, MRI still ha...Differentiation between neoplastic and nonneoplastic conditions magnetic resonance imaging(MRI) has established itself as one of the key clinical tools in evaluation of musculoskeletal pathology. However, MRI still has several key limitations which require supplemental information from additional modalities to complete evaluation of various disorders. This has led to the development hybrid positron emission tomography(PET)-MRI which is rapidly evolving to address key clinical questions by using the morphological strengths of MRI and functional information of PET imaging. In this article, we aim to review physical principles and techniques of PET-MRI and discuss clinical utility of functional information obtained from PET imaging and structural information obtained from MRI imaging for the evaluation of musculoskeletal pathology. More specifically, this review highlights the role of PET-MRI in musculoskeletal oncology including initial diagnosis and staging, treatment planning and posttreatment follow-up. Also we will review utility of PET-MRI in evaluating musculoskeletal infections(especially in the immunocompromised and diabetics) and inflammatory condition. Additionally, common pitfalls of PET-MRI will be addressed.展开更多
目的:分析毛细血管扩张型骨肉瘤影像学表现与病理的关系,以提高诊断准确性。方法:回顾性分析经手术病理证实的毛细血管扩张型骨肉瘤9例,术前分别经X线平片、CT平扫、MR SE T_1WI、T_2WI和T_1WI增强扫描,仔细复习影像征象并和手术病理作...目的:分析毛细血管扩张型骨肉瘤影像学表现与病理的关系,以提高诊断准确性。方法:回顾性分析经手术病理证实的毛细血管扩张型骨肉瘤9例,术前分别经X线平片、CT平扫、MR SE T_1WI、T_2WI和T_1WI增强扫描,仔细复习影像征象并和手术病理作对照。结果:9例毛细血管扩张型骨肉瘤中,位于股骨5例,胫骨3例和髂骨1例。位于长管状骨者,5例位于干骺端,2例位于骨干,1例接近骨端。肿瘤直径6.3～11.8 cm。所有肿瘤均为溶骨性骨质破坏,破坏区呈椭圆形5例,不规则地图形4例。病灶呈囊状9例,7例病灶境界不清,7例病变见骨膜增生,伴软组织肿块8例,所有病例软组织肿块境界清楚。5例行CT检查,病灶密度低于肌肉或与肌肉相仿,CT显示骨膜增生及软组织肿块较平片清楚,增强扫描软组织明显强化。4例行MR检查,T_1WI为混杂信号3例,低信号1例;T_2WI为低、等和高信号混杂4例。T_2WI 4例均可见明显囊状改变和液-液平面,均可见软组织成分,软组织构成囊壁和分隔,部分呈不规则肿块结节,T_2WI软组织信号高于肌肉。结论:毛细血管扩张型骨肉瘤好发于长管状骨干骺端,呈卵圆形或地图样溶骨性破坏,容易呈多囊状坏死,但肿瘤内常见软组织成分,常伴骨膜增生和骨外软组织肿块,CT增强扫描和MR有助于显示病灶的软组织成分。展开更多
文摘Differentiation between neoplastic and nonneoplastic conditions magnetic resonance imaging(MRI) has established itself as one of the key clinical tools in evaluation of musculoskeletal pathology. However, MRI still has several key limitations which require supplemental information from additional modalities to complete evaluation of various disorders. This has led to the development hybrid positron emission tomography(PET)-MRI which is rapidly evolving to address key clinical questions by using the morphological strengths of MRI and functional information of PET imaging. In this article, we aim to review physical principles and techniques of PET-MRI and discuss clinical utility of functional information obtained from PET imaging and structural information obtained from MRI imaging for the evaluation of musculoskeletal pathology. More specifically, this review highlights the role of PET-MRI in musculoskeletal oncology including initial diagnosis and staging, treatment planning and posttreatment follow-up. Also we will review utility of PET-MRI in evaluating musculoskeletal infections(especially in the immunocompromised and diabetics) and inflammatory condition. Additionally, common pitfalls of PET-MRI will be addressed.
文摘目的:分析毛细血管扩张型骨肉瘤影像学表现与病理的关系,以提高诊断准确性。方法:回顾性分析经手术病理证实的毛细血管扩张型骨肉瘤9例,术前分别经X线平片、CT平扫、MR SE T_1WI、T_2WI和T_1WI增强扫描,仔细复习影像征象并和手术病理作对照。结果:9例毛细血管扩张型骨肉瘤中,位于股骨5例,胫骨3例和髂骨1例。位于长管状骨者,5例位于干骺端,2例位于骨干,1例接近骨端。肿瘤直径6.3～11.8 cm。所有肿瘤均为溶骨性骨质破坏,破坏区呈椭圆形5例,不规则地图形4例。病灶呈囊状9例,7例病灶境界不清,7例病变见骨膜增生,伴软组织肿块8例,所有病例软组织肿块境界清楚。5例行CT检查,病灶密度低于肌肉或与肌肉相仿,CT显示骨膜增生及软组织肿块较平片清楚,增强扫描软组织明显强化。4例行MR检查,T_1WI为混杂信号3例,低信号1例;T_2WI为低、等和高信号混杂4例。T_2WI 4例均可见明显囊状改变和液-液平面,均可见软组织成分,软组织构成囊壁和分隔,部分呈不规则肿块结节,T_2WI软组织信号高于肌肉。结论:毛细血管扩张型骨肉瘤好发于长管状骨干骺端,呈卵圆形或地图样溶骨性破坏,容易呈多囊状坏死,但肿瘤内常见软组织成分,常伴骨膜增生和骨外软组织肿块,CT增强扫描和MR有助于显示病灶的软组织成分。
