Characteristic MRI Findings of Spinal Metastases from Various Primary Cancers: Retrospective Study of Pathologically-Confirmed Cases
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Purpose : The purpose of this study was to find and categorize the various magnetic resonance imaging (MRI) findings of spinal metastases that correlate with the type of primary cancer. Materials and Methods: We retrospectively reviewed gadolinium-enhanced magnetic resonance images of 30 patients with 169 spinal metastatic lesions from lung cancer (n = 56), breast cancer (n = 29), colorectal cancer (n = 20), hepatocellular carcinoma (HCC) (n = 17), and stomach cancer (n = 47). The size, location, extent of invasion, signal intensity, margin,enhancement pattern, and osteoblastic or osteolytic characteristics of each metastatic tumor were analyzed. Results: The metastatic lesions from HCC were larger than those from the other primary tumors (P < 0.05) except for colorectal cancer (P = 0.268). Well-defined metastatic tumor margins were more frequently seen in lung cancer and breast cancer (P < 0.01). All but HCC showed a tendency to invade the vertebral body rather than the posterior elements (P <0.02). Colorectal cancer and HCC showed a tendency toward extraosseous invasion without statistical significance. HCC showed a characteristic enhancement pattern of ‘worms-in-a-bag’. Rim enhancement with a sclerotic center was only seen in spinal metastases from stomach cancer. Conclusion: Despite many overlapping imaging features, spinal metastases of various primary tumors display some characteristic MRI findings that can help identify the primary cancer.
Abstract
Purpose : The purpose of this study was to find and categorize the various magnetic resonance imaging (MRI) findings of spinal metastases that correlate with the type of primary cancer. Materials and Methods: We retrospectively reviewed gadolinium-enhanced magnetic resonance images of 30 patients with 169 spinal metastatic lesions from lung cancer (n = 56), breast cancer (n = 29), colorectal cancer (n = 20), hepatocellular carcinoma (HCC) (n = 17), and stomach cancer (n = 47). The size, location, extent of invasion, signal intensity, margin,enhancement pattern, and osteoblastic or osteolytic characteristics of each metastatic tumor were analyzed. Results: The metastatic lesions from HCC were larger than those from the other primary tumors (P < 0.05) except for colorectal cancer (P = 0.268). Well-defined metastatic tumor margins were more frequently seen in lung cancer and breast cancer (P < 0.01). All but HCC showed a tendency to invade the vertebral body rather than the posterior elements (P <0.02). Colorectal cancer and HCC showed a tendency toward extraosseous invasion without statistical significance. HCC showed a characteristic enhancement pattern of ‘worms-in-a-bag’. Rim enhancement with a sclerotic center was only seen in spinal metastases from stomach cancer. Conclusion: Despite many overlapping imaging features, spinal metastases of various primary tumors display some characteristic MRI findings that can help identify the primary cancer.
참고문헌 (17)
- Boland PJ, "Metastatic disease of the spine", Clin Orthop Relat Res, 169, pp.95~102 (1982)
- Schiff D, "Spinal epidural metastasis as the initial manifestation of malignancy: clinical features and diagnostic approach", Neurology, 49, pp.452~456 (1997)
- Berrettoni BA, "Mechanisms of cancer metastasis to bone. J Bone Joint Surg Am", American volume, 68, pp.308~312 (1986)
- Guillevin R, "Spine metastasis imaging: review of the literature", J Neuroradiol, 34, pp.311~321 (2007)
- Daugaard G, "Unknown primary tumours", Cancer Treat Rev, 20, pp.119~147 (1994)
- Abbruzzese JL, "Unknown primary carcinoma: natural history and prognostic factors in 657 consecutive patients", J Clin Oncol, 12, pp.1272~1280 (1994)
- Katagiri H, "Determining the site of the primary cancer in patients with skeletal metastasis of unknown origin: a retrospective study", Cancer, 86, pp.533~537 (1999)
- Brihaye J, "The management of spinal epidural metastases", Adv Tech Stand Neurosurg, 16, pp.121~176 (1988)
- Ghanem N, "Diagnostic value of MRI in comparison to scintigraphy, PET, MS-CT and PET", CT for the detection of metastases of bone, 2005, pp.55, 41~55
- Chiewvit P, "Does magnetic resonance imaging give value-added than bone scintigraphy in the detection of vertebral metastasis?", Chot Mai Het Thang Phaet, 92, pp.818~829 (2009)
- Beltran J, "Tumors of the osseous spine: staging with MR imaging versus CT", Radiology, 162, pp.565~569 (1987)
- Keogh C, "MR imaging of bone tumors of the cervical spine", Magn Reson Imaging Clin N Am, 8, pp.513~528 (2000)
- Ross JS, "Diagnostic imaging: Spine" (2010), Amirsys
- Sugimura K, "Assessing response to therapy of spinal metastases with gadolinium-enhanced MR imaging", J Magn Reson Imaging, 1, pp.481~484 (1991)
- Sneag DB, "Extrahepatic spread of hepatocellular carcinoma: spectrum of imaging findings", AJR Am J Roentgenol, 197, pp.W658~W664 (2011)
- Katyal S, "Extrahepatic metastases of hepatocellular carcinoma", Radiology, 216, pp.698~703 (2000)
- Hyo Jung Seo, "Evaluation of Bone Metastasis from Hepatocellular Carcinoma Using 18F-FDG PET", CTand 99mTc-HDP Bone Scintigraphy: Characteristics of Soft Tissue Formation, 2011, pp.45(3), 203~211[DOI]