대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제63권2호
  • /
  • Pages.177-183
  • /
  • 2010
  • /
  • 1738-2637(pISSN)
  • /
  • 2951-0805(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지

지방육종의 조직학적 악성도 예측을 위한 자기공명영상 소견의 수정 분류

Modified Classification of MRI Findings to Predict Histologic Grading of Liposarcomas

  • 문태용 (부산대학교 의학전문대학원 영상의학교실) ;
  • 이인숙 (부산대학교 의학전문대학원 영상의학교실) ;
  • 황인경 (부산대학교 의학전문대학원 예방의학교실) ;
  • 양익 (한림대학교 강남성심병원 영상의학과) ;
  • 이선주 (인제대학교 백병원 영상의학과) ;
  • 최윤영 (부산대학교 의학전문대학원 영상의학교실)
  • Moon, Tae-Yong (Department of Radiology, School of Medicine, Pusan National University) ;
  • Lee, In-Sook (Department of Radiology, School of Medicine, Pusan National University) ;
  • Hwang, In-Kyung (Department of Preventive Medicine, School of Medicine, Pusan National University) ;
  • Yang, Ik (Department of Radiology, Hallym University Kangnam Sacred Heart Hospital) ;
  • Lee, Sun-Joo (Department of Radiology, Inje University Baik Hospital) ;
  • Choi, Yoon-Young (Department of Radiology, School of Medicine, Pusan National University)
  • 투고 : 2010.02.08
  • 심사 : 2010.05.09
  • 발행 : 2010.08.01
⟨ 이전 논문 다음 논문 ⟩

초록

목적: 지방육종의 병리조직학적 악성도를 새로 분류한 자기공명영상 소견으로 예측하기 위함이다. 대상과 방법: 병리조직학적 지방육종은 분화성 17예, 점액지질 16예, 둥근세포 9예, 뭇형성 5예였다. 악성도는 점액지질육종 16예를 낮은 악성 그리고 둥근세포지방육종과 뭇형성지방육종 14예를 높은 악성으로 나누었다. T1 강조영상에서 지방 80% 이상, 20-80% 사이, 20% 이하, 그리고 지방 없음으로 나누고, T2 강조영상은 높은 신호강도 소견이 망사모양이나 불규칙한 선형, 균질하게 범위 50% 이상, 비 균질하게 50% 이상, 그리고 조영제주입 지방감산 T1 강조영상에서 조영증강 소견이 망사모양이나 불규칙한 선형, 균질하게 50% 이상, 깃털이나 소용돌이 모양, 비 균질하게 50% 이상, 중앙무혈관병소로 변두리 조영증강 소견으로 분류하였다. 결과: T1 강조영상에서 지방성분이 적을수록 악성도는 높았다 (p = 0.026). T2 강조영상에서 비균질한 높은 신호강도 소견이 범위50% 이상이면 악성도가 높았다(p = 0.010). 그러나 조영제주입 지방감산 T1 강조영상에서 범위 50% 이하 조영증강 소견이 악성도를 반영하지는 않았다(p = 0.070). 결론: 새로 분류한 MR 소견으로 지방육종의 병리조직학적 악성도를 예측할 수 있었다.

Purpose: To predict the histopathologic grading of liposarcomas with the modified classification of MRI findings. Materials and Methods: The 47 MRI studies of pathologically confirmed liposarcomas were retrospectively analyzed, and found to have well-differentiated (n=17) and myxoid (n=16) types, representing the 'low grade' sarcomas, as well as the round cell (n=9) and pleomorphic (n=5) types, which represent the 'high grade' sarcomas. The MRI findings of liposarcomas were classified into four groups as the one with fat signal above 80%, 20-80%, below 20%, and no fat signal on T1-weighted images (WIs), into three groups as the one with high signals with reticular or irregular lines, homogeneous above 50% of the area, and heterogeneous above 50% on the T2WIs, and into three groups as the one enhanced with reticular or irregular lines and enhancement areas above 50% and below 50% on the Gd-DTPA T1WIs. Results: The sarcomas with a lower amount of fat signals on T1WIs had a significantly higher histologic grade (p = 0.026) and also showed heterogeneous high signals above 50% on the T2WIs was statistically significant difference (p = 0.010) but not on the contrast enhanced T1WIs (p = 0.070). Conclusion: The modified classification of the MR findings could help predict the histologic grading of liposarcomas.

키워드

과제정보

연구 과제 주관 기관 : 부산대학교

참고문헌

  1. Reszel PA, Soule EH, Coventry MB. Liposarcoma of the extremities and limb girdles: a study of 222 cases. J Bone Joint Surg Am 1966;48:229-244 https://doi.org/10.2106/00004623-196648020-00002
  2. Kransdorf MJ. Malignant soft-tissue tumors in a large referral population: distribution of diagnoses by age, sex, and location. AJR Am J Roentgenol 1995;164:129-134 https://doi.org/10.2214/ajr.164.1.7998525
  3. Jelinek JS, Kransdorf MJ, Shmookler BM, Aboulafia AJ, Malawer MM. Liposarcoma of the extremities: MR and CT findings in the histologic subtypes. Radiology 1993;186:455-459 https://doi.org/10.1148/radiology.186.2.8421750
  4. Kim JI, Choi KU, Lee IS, Moon TY, Lee CH, Kim HW, et al. Gene expression in mixed type liposarcoma. Pathology 2006;38:114-119 https://doi.org/10.1080/00313020600557078
  5. Fletcher CD, Unni KK, Mertens F. Pathology and genetics of tumours of soft tissue and bone. Lyon, France: IARC, 2002
  6. Tateishi U, Hasegawa T, Beppu Y, Kawai A, Satake M, Moriyama N. Prognostic significance of MRI findings in patients with myxoid- round cell liposarcoma. AJR Am J Roentgenol 2004;182:725-731 https://doi.org/10.2214/ajr.182.3.1820725
  7. Arkun R, Memis A, Akalin T, Ustun EE, Sabah D, Kandiloglu G. Liposarcoma of soft tissue: MRI findings with pathologic correlation. Skeletal Radiol 1997;26:167-172 https://doi.org/10.1007/s002560050214
  8. Kransdorf MJ, Moser RP, Meis JM, Meyer CA. Fat containing soft tissue masses of the extremities. Radiographics 1991;11:81-106
  9. Wu JS, Hochman MG. Soft-tissue tumors and tumorlike lesions: a systematic imaging approach. Radiology 2009;253:297-316 https://doi.org/10.1148/radiol.2532081199
  10. Orson GG, Sim FH, Reiman HM, Taylor WF. Liposarcoma of the musculoskeletal system. Cancer 1987;60:1362-1270 https://doi.org/10.1002/1097-0142(19870915)60:6<1362::AID-CNCR2820600634>3.0.CO;2-1
  11. Kransdorf MJ, Bancroft LW, Peterson JJ, Murphey MD, Foster WC, Temple HT. Imaging of fatty tumors: distinction of lipoma and well-differentiated liposarcoma. Radiology 2002;224:99-104 https://doi.org/10.1148/radiol.2241011113
  12. Sung MS, Kang HS, Suh JS, Lee JH, Park JM, Kim JY, et al. Myxoid liposarcoma: appearance at MR imaging with histologic correlation. Radiographics 2000;20:1007-1019
  13. Enzinger FM, Weiss SW. Soft tissue tumors. 2nd ed. St Louis: Mosby, 1988:346-382
  14. Song T, Shen J, Liang BL, Mai WW, Li Y, Guo HC. Retroperitoneal liposarcoma: MR characteristics and pathological correlative analysis. Abdom Imaging 2007;32:668-674 https://doi.org/10.1007/s00261-007-9220-6
  15. Baur A, Bartl R, Pellengahr C, Baltin V, Peiser M. Neovascularization of bone marrow in patients with diffuse multi-ple myeloma. Cancer 2004;101:2599-2604 https://doi.org/10.1002/cncr.20697
  16. 문태용, 이인숙, 이지원, 김정일, 최경운, 김원택. 290예 연조직종 양의 자기공명 해부조직학적 분포. 대한영상의학회지 2008;59:417-427