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(Radiology. 2000;214:539-546.)
© RSNA, 2000

Musculoskeletal Imaging

Cartilaginous Tumors: Fast Contrast-enhanced MR Imaging1

Maartje J. A. Geirnaerdt, MD, Pancras C. W. Hogendoorn, MD, Johan L. Bloem, MD, Antonie H. M. Taminiau, MD and Henk-Jan van der Woude, MD

1 From the Departments of Radiology (M.J.A.G., J.L.B., H.J.v.d.W.), Pathology (P.C.W.H.), and Orthopedic Surgery (A.H.M.T.), Leiden University Medical Center, C2-S, Albinusdreef 2, P.O. Box 9600, 2300 RC Leiden, the Netherlands. From the 1996 RSNA scientific assembly. Received February 3, 1998; revision requested April 9, 1999; final revision received May 3; accepted June 28. Address reprint requests to M.J.A.G. (e-mail: j.l.bloem@radiology.azl.nl).

PURPOSE: To differentiate between benign and malignant cartilaginous tumors with fast contrast material–enhanced magnetic resonance (MR) imaging.

MATERIALS AND METHODS: In 37 patients, fast contrast-enhanced MR images were obtained in eight enchondromas, 11 osteochondromas, and 18 chondrosarcomas. Start of enhancement—early, within 10 seconds after arterial enhancement; delayed, between 10 seconds and 2 minutes; late, after 5 minutes on spin-echo images—and progression of enhancement were represented with three types of time–signal intensity curves. Findings were correlated with the surgical specimen in 27 cases, curettage material in three cases, and biopsy combined with long-term follow-up findings in seven cases.

RESULTS: Start of enhancement and the combination of start and progression of enhancement correlated significantly (P < .001) with benign and malignant tumors. Early enhancement was seen in chondrosarcoma, not seen in enchondroma, and seen in osteochondroma only when growth plates were unfused. The sensitivity was 89%, specificity 84%, positive predictive value 84%, and negative predictive value 89%. Differentiation of malignancy from benignity on the basis of early and exponential enhancement was possible with a sensitivity of 61%, specificity 95%, positive predictive value 92%, and negative predictive value 72%.

CONCLUSION: Preliminary results show that in the adult population fast contrast-enhanced MR imaging may assist in differentiation between benign and malignant cartilaginous tumors.

Index terms: Cartilage, MR, 40.121411, 40.121412, 40.12143 • Chondrosarcoma, 40.3211 • Enchondroma, 40.351 • Osteochondroma, 40.351 • Osteosarcoma, 40.322 • Sarcoma, 40.3211 • Soft tissues, MR, 40.12143




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