A comparative study on CT and pathological examinations of intramedullary extension of appendicular ;osteosarcomas
DENG Zhi-ping
DING Yi
SU Yong-bin
NIU Xiao-hui
Abstract：Objective To investigate the accuracy of simple CT measurement of intramedullary lengths of appendicular osteosarcomas. Methods The intramedullary tumor lengths of 81 patients with appendicular osteosarcomas were measured by CT, whose data were retrospectively studied. There were 46 males and 35 females, whose median age was 15 years old ( range;10-60 years ). The tumors were located at the distal femur in 45 patients, at the proximal tibia in 23 patients, at the proximal humerus in 10 patients, at the proximal femur in 2 patients and at the distal tibia in 1 patient. The CT was from the imaging station. The length was calculated from the joint level to the tumor margin. At the proximal femur, the length was measured from the tip of the greater trochanter to the tumor margin. All patients accepted tumor segment resection. The pathological measurement of tumor lengths was carried out postoperatively. The tumor lengths by CT and pathological measurements were compared, which were analyzed statistically. Results The tumor lengths by CT and pathological measurements in 81 patients were compared using the paired t-test, and there were statistically significant differences between them ( t=5.185, P<0.01). In 52 cases, the error was within 1cm, and the accuracy rate was 64.2%. The tumor lengths of the 52 cases by CT and pathological measurements were compared using the paired t-test, and there were statistically signiifcant differences between them ( t=-0.51, P=0.959 ). In the other 29 cases, the error was more than 1cm, and the tumor lengths by CT measurement were longer than that by pathological measurement. The mean error was 110 mm ( range;16-262 mm ). For the cavum medullare amputated, CT examination showed abnormal signs, and while pathological examination showed tumor-free signs. The CT values of this part were in the range of-28-45 HU before enhancement and-10-87 HU after enhancement. According to the histological analysis, the extra parts of the cavum medullare by CT measurement were hematopoietic cell proliferation of erythrocyte series, leukocytic series and thrombocytic series, and tumor cells were not found. Conclusions The accuracy of simple CT measurement of intramedullary lengths of appendicular osteosarcomas is not acceptable. The osteosarcoma and hyperplastic bone marrow can’t be differentiated just by CT measurement. Other imaging modalities can help make the measurement more precise, so as to guide the limb salvage surgery.
Keywords：OsteosarcomaDiagnostic techniques and proceduresTomographyX-ray computedPathologysurgical
Publication Date：2013-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 495-498 )