· pdf filewho 1. conventional os a osteoblastic type b chondroblastic type c fibroblastic...

1. osteosarcomas

2. chondrosarcoma

3. Ewing sarcoma

4. malignant fibrous histiocytoma

5. myeloma

6. malignant lymphoma of bone

1.

geographic moth-eaten permeative

2.

3.

4.

Codman onion peel sunburst(spiculated)

5.

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

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

conventional central OS

1.

2.

50 100 1 ( 130-260 )

15 10 >20 >10 >

2 5

3.

3-4

10

Sunburst

Codman

21817448

MRIMRI

T1T1

T2T2

sunburstsunburst

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

grade2

Grade0 50-100%

Grade1 10-50%

Grade2 10

Grade3

2008/9/24

2008/9/5

2008/7/1

2008/7/11

2006/10/12 2007/11/16

70 Paget OS21549176

Paget

50

OS 50%

MFH25%

47

parosteal OS

1.

(surface osteosarcoma)

2.

4% ( : =1:2) 20

30

3.

60%

50

MRI

telangiectatic OS

1.

X

(high-grade)

2.

2.6-4.3% : =3:2

3.

70

21899495

MRI

T1T2

ABC fluid-fluid

level

ABC

)

chondrosarcoma

1. conventional CHS

a. primary CHS

b. ( ) periosteal CHS

c. secondary CHS

2. dedifferentiated CHS

3. mesenchymal CHS

4. clear-cell CHS

chondrosarcoma

1.

2.

11-27%

30-50

3.

45%(

49% 36%) 25 8% 7% 5%

60

erosion (endostealerosion)

21727210

MRI

T1 T2

ring and arc

enhancement

endosteal scalloping

2/3

T1WI

entraped fat entraped fat ( )

T2WI - - -

CE ring and arc ring and arc ring and arc

+

Yoo HJ. Eur Radiol 2009

periosteal CHS

1.

2.

4% 30-40

3.

40

erosion

Codman

MR

secondary CHS

1.

2.

5-25

(Ollier ) 30-50

20 50

3.

50

1.5-2cm1.5-2cm

Ewing sarcoma

1.

PNET(primitive neuroectodermal tumor)

Ewing

2.

6-10% ( )

10 80%( 13 30 : =3:2

3.

CRP LDH 2/3

4

Moth-eaten onion peel sunburst

21886938

MRI

T1

T2

erosion

malignant fibrous histiocytoma (MFH) of bone

1.

(striform pattern)

MFH 30%

2.

2 20 45 2

40

3.

7-9

30-45

60

38

MRIMRI

GCTGCT

21518408

myeloma

1.

( )

(

) (

) 20

1 M

2.

35 60-70 40

3.

Ca

60

(punched(punched out)out)

21761922

MRIMRI

T1T1 T2T2

variegate patternvariegate pattern))

primary malignant lymphoma of bone1.

9

non-Hodgkin B cell lymphoma

2.

3 20 50

2 40

3.

25

30

(ivory vertebra )

MRIMRI

T1T2T1T2

21440260

1. osteosarcomas

2. chondrosarcoma

3. Ewing sarcoma

4. malignant fibrous histiocytoma

5. myeloma

6. malignant lymphoma of bone