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OBJECTIVE: To correlate the T2-weighted and STIR MRI appearances of dedifferentiated appendicular chondrosarcoma with gross and microscopic pathology. DESIGN AND PATIENTS: Nine patients with a histologically confirmed diagnosis of dedifferentiated appendicular chondrosarcoma were identified from the Bone Tumour Registry. All patients underwent MRI, including T2-weighted and/or STIR sequences in at least one plane, prior to limb salvage surgery. Areas of reduced signal intensity (SI) compared with hyperintense chondral tumour on the T2-weighted or STIR images were correlated with the resection specimen, to determine the relationship of such out areas of reduced SI with regions of dedifferentiation. RESULTS AND CONCLUSIONS: Patients presented over a period of 7 years. There were five men and four women with mean age 68.2 years and age range 51-78 years. Tumours arose in the femur (6 cases), humerus (2 cases) and tibia (1 case). Three MRI patterns were identified: (1) type 1, a lesion with two distinct signal characteristics-hyperintense chondral and reduced SI dedifferentiated tumour (n=6); type 2, mainly reduced SI lesion-dedifferentiated tumour, with areas of signal void corresponding to matrix calcification (n=2); type 3, a heterogeneous lesion with no radiological evidence of underlying chondral tumour (n=1). T2-weighted or STIR MR sequences can identify areas of dedifferentiation, which should be the preferential site of pre-operative biopsy.

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目的：关联的T2加权和STIR MRI表现去分化软骨肉瘤的阑尾总值和微观病理。设计与患者： 9例有病理确诊的去分化软骨肉瘤阑尾确定了从骨肿瘤登记处。所有患者接受MRI检查，包括T2加权和/或搅拌序列至少一架飞机之前，保肢手术。地区减少信号强度（ SI ）的比较高软骨肿瘤的T2加权或搅拌图像与切除标本，以确定这种关系的领域，减少了司与区域分化。结果和结论：病人经过一段七年。有五男四女，平均年龄六十八点二年和年龄范围51-78岁。肿瘤发生在股骨（ 6例），肱骨（ 2例）和胫骨（ 1例）。三磁共振成像模式被确定：（ 1 ） 1型，一个病变的两种不同的信号特征，高软骨和减少司分化肿瘤（ 6例） ; 2型，主要是减少司病灶分化肿瘤，与地区相应的信号无效矩阵钙化（ 2例） ; 3型，异质性病变，没有放射性的证据根本软骨瘤（ 1例）。 T2加权或搅拌问序列可以识别领域的分化，这应该是网站的优惠术前活检。

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PURPOSE: To develop a new mathematical model for calculating the volumetric wear of polyethylene cups from known values of the radius of the prosthesis head, the extent of linear wear and the direction of linear wear determined from standard antero-posterior radiographs. METHOD: A new mathematical model was developed. The results of this new mathematical model were compared with the results obtained using the standard, frequently used mathematical model, which takes into consideration only the radius of the prosthesis head and the extent of linear wear of the polyethylene cups. The results of both mathematical models were further compared with the results obtained by direct measurement of volumetric wear using the fluid displacement method. RESULTS: Comparison of the mathematical models shows that the average volumetric wear calculated using the new mathematical model is 8.5% smaller than the average volumetric wear determined by the fluid displacement method, while the average volumetric wear calculated by standard mathematical model is 17.5% higher. The results of the new mathematical model are, thus, notably less biased than those of the standard one. CONCLUSION: In calculating the volumetric wear from antero-posterior radiographs, not only the radius of the prosthesis head and the extent of the linear wear but also the direction of the latter has to be considered.

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目的：开发一种新的数学模型，计算体积磨损的聚乙烯杯已知值半径的假头，线性程度的磨损和方向线性磨损确定标准安特罗，后X光片。方法：一种新的数学模型。结果这个新的数学模型进行比较，得到的结果运用标准，常用的数学模型，其中考虑到只有半径的假肢头部和磨损程度的线性聚乙烯杯。成果的数学模型，进一步相比所取得的成果直接测量体积磨损使用流体位移法。结果：比较数学模型表明，平均体积磨损计算的新的数学模型是小于8.5 ％的平均体积磨损所确定流体位移法，而平均体积磨损标准计算数学模型，为17.5 ％更高。结果新的数学模型，因此，特别是较少偏见比标准之一。结论：在计算容积磨损安特罗，后片，不仅半径的假体头部和程度的磨损，而且还直线方向后者必须考虑到。

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OBJECTIVE: To describe the radiographic features of clear cell chondrosarcoma (CCCS), including the computed tomographic (CT) and magnetic resonance (MR) findings, and to correlate them with the histopathologic findings. DESIGN AND PATIENTS: A retrospective review was carried out of 72 patients with histopathologically confirmed CCCS. Imaging studies were available for 34 patients: conventional radiographs (n=28), CT scans (n=14), and MR images (n=15). Radiographic studies were reviewed by three radiologists who rendered a consensus opinion; the studies were correlated with the histopathologic findings. RESULTS: Of the 34 patients with imaging studies, 30 were male and 4 were female (mean age 38.6 years; range 11-74 years). Twenty-two lesions were in long bones (15, proximal femur; 1, distal femur; 1, proximal tibia; 5, proximal humerus) and 11 were in flat bones (5, vertebra; 4, rib; 1, scapula; 1, innominate). One lesion occurred in the tarsal navicular bone. Typically, long bone lesions were located in the epimetaphysis (19/22) and were lucent with a well-defined sclerotic margin and no cortical destruction or periosteal new bone formation. More than one-third of the long bone lesions contained matrix mineralization with a characteristic chondroid appearance. Pathologic fractures were present in six long bone lesions (4, humerus; 2, femur). Lesions in the proximal humerus were more likely to have indistinct margins (4/5) and extend into the diaphysis. Flat bone lesions were typically lytic and expansile and occasionally demonstrated areas of cortical disruption. Typically, matrix mineralization, when present, was amorphous. MR imaging, when available, was superior to conventional radiographs for demonstrating the intramedullary extent of a lesion as well as soft tissue extension. CT images better delineated the presence of cortical destruction and the character of matrix mineralization patterns. CCCS lesions were typically low signal intensity on T1-weighted images and moderately or significantly bright on T2-weighted images. Areas of lesion heterogeneity on T1- and T2-weighted images and on post-gadolinium T1-weighted images corresponded pathologically to areas of mineralization, intralesional hemorrhage, and cystic changes. Adjacent bone marrow edema was typically absent (12/15) or only minimally observed in a few cases (3/15). No cases examined with MR imaging demonstrated periosteal new bone formation. CONCLUSIONS: CCCS typically presents radiographically as a geographic lytic lesion located in the epimetaphyseal region of long bones. Most commonly lesions are found in the proximal femur, followed by the proximal humerus. Lesions within the proximal humerus may exhibit more aggressive features. Lesions in the axial skeleton are typically expansile and destructive, often with soft tissue extension and lack of mineralization. MR imaging may show the presence or absence of bone marrow edema.

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目的：描述影像学表现透明细胞软骨肉瘤（共同事务协商委员会），包括电脑断层（ CT表现）和磁共振（先生）的调查结果，并与他们相关的病理结果。设计与患者：回顾进行了72例病理证实共同事务协商。影像学研究，可用于34例：常规X线片（ 28例）， CT扫描（ 14例），和MR影像（ 15例）。射线研究审查了三个放射谁作出了共识意见;相关的研究与病理结果。结果： 34例影像学， 30名男性和4名女性（平均年龄三十八点六年;范围11-74岁）。 22个病灶在长骨（ 15岁，股骨近端; 1 ，股骨远端; 1 ，胫骨近端; 5 ，肱骨近端）， 11人在扁骨（ 5 ，脊椎骨; 4 ，肋骨; 1 ，肩胛骨; 1 ，无名）。一个病变发生在跗舟骨。通常情况下，长骨病灶位于epimetaphysis （ 19/22 ）和朗讯公司分别与一个明确的硬化边缘，没有皮质毁坏或骨膜新骨形成。超过三分之一的长骨病变与载矩阵矿化特征软骨外观。病理性骨折中有6个长骨病变（ 4 ，肱骨; 2 ，股骨）。病变的肱骨近端容易模糊利润率（ 4月5日）和延伸到骨干。扁骨病变通常溶解和膨胀，偶尔显示领域的皮质破坏。一般来说，基质矿化，当本，是非晶态。磁共振成像时，可用，明显优于传统的X光片表明髓内程度的损伤以及软组织延长。 CT图像更好地界定存在皮质破坏和性质的矩阵矿化模式。共同事务协商委员会病变通常是低信号强度对T1加权图像和中度或显着明亮的T2加权图像。异质性领域的病变在T1和T2加权图像和后钆T1加权图像对应病理地区矿化，注射出血，囊性改变。邻近骨髓水肿一般不在（ 12月15日），或只有微观察在少数情况下（ 3月15日）。任何情况下与磁共振成像检查表明骨膜新骨形成。结论：共同事务协商委员会提出了X线通常作为一个地理溶解病变位于epimetaphyseal地区的长骨。最常见的病灶被发现在股骨近端，其次是肱骨近端。病灶内肱骨近端可能会更积极的功能。病变的骨架通常轴向膨胀和破坏性，往往是软组织推广和缺乏矿化。磁共振成像显示可能存在或不存在的骨髓水肿。

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OBJECTIVE: To assess the usefulness of dynamic magnetic resonance imaging (DMRI) in the diagnosis of soft tissue tumors. DESIGN AND PATIENTS: A DMRI series of 33 patients with soft tissue lesions was evaluated with regard to start, pattern, and progression of enhancement. Early enhancement, predominantly peripheral, and a time-signal intensity (TSI) curve characterized by a steep rise to an early peak followed by a plateau or washout, were considered signs of malignancy. The results were compared with the initial fine needle aspiration cytology (FNAC) diagnosis and the final diagnosis. RESULTS: Twenty of 23 malignant lesions and three of 10 benign lesions exhibited at least two of the three enhancement characteristics attributed to malignancy. Using two or more DMRI features of malignancy to dichotomize the series, the sensitivity and positive predictive value of the DMRI series were 87% and, the specificity and negative predictive value were 70%. FNAC was conclusive except in two cases. CONCLUSION: In tumor centers that rely on FNAC for preoperative diagnosis DMRI can be reserved for cytologically inconclusive cases. In centers that rely on open biopsy, DMRI may be useful as a coarse discriminator between benign and malignant lesions. However, larger series of soft tissue tumors need to be evaluated to conclusively identify the clinical role of DMRI.

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目的：评价是有用的动态磁共振成像（ DMRI ）诊断中的软组织肿瘤。设计与患者：一个DMRI一系列的33例软组织病变方面的评估开始，模式，加强和发展。早期强化，主要是外设，和一个时间信号强度（抗体）曲线的特点是急剧上升早日高峰之后，高原或冲洗，被认为是恶性的迹象。结果进行了比较与最初的细针穿刺细胞学检查（细胞学）诊断和最后诊断。结果： 20 23恶性病变和三个10良性病变展出至少有两个特点三个增强归因于恶性肿瘤。使用两个或两个以上的DMRI特点恶性肿瘤，以二分的系列，其敏感性和阳性预测值的DMRI系列87 ％和，特异性和阴性预测值分别为70 ％。细胞学是决定性的，除非在两起案件。结论：在肿瘤中心，依靠细胞学的术前诊断DMRI可以保留细胞学定论案件。在中心，依靠开放活检， DMRI可能是有用的作为一个粗略鉴别良，恶性病变。然而，更大的一系列软组织肿瘤的需要加以评估，以确定最后的临床作用DMRI 。

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OBJECTIVE: To characterize the radiological and clinicopathologic features of cystic synovial sarcoma. DESIGN AND PATIENTS: Seven patients with primary cystic synovial sarcoma were evaluated. Computed tomography (CT) and magnetic resonance (MR) imaging were undertaken at the first presentation. The diagnosis of synovial sarcoma was made on the basis of histological examinations followed by molecular analysis. Radiological and clinicopathologic findings were reviewed. RESULTS: CT showed well-defined soft tissue mass without cortical bone erosion and invasion. Calcification was seen at the periphery of the mass in three cases. T2-weighted MR images showed multilocular inhomogeneous intensity mass in all cases, five of which showed fluid-fluid levels. On gross appearance, old and/or fresh hematomas were detected in six cases. In the one remaining case, microscopic hemorrhage in the cystic lumen was proven. Four cases had poorly differentiated areas. In five cases prominent hemangiopericytomatous vasculature was observed. Histologic grade was intermediate in one tumor and high in six. One case had a history of misdiagnosis for tarsal tunnel syndrome, one for lymphadenopathy, two for sciatica and two for hematoma. CONCLUSION: All cystic synovial sarcomas demonstrated multilocularity with well-circumscribed walls and internal septae. Synovial sarcoma should be taken into consideration in patients with deeply situated multicystic mass with triple signal intensity on T2-weighted MR imaging.

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目的：表征放射性和临床病理特征的囊性滑膜肉瘤。设计与患者： 7例原发性囊性滑膜肉瘤进行了评价。计算机断层扫描（ CT ）和核磁共振（先生）成像技术进行了第一次演讲。诊断为滑膜肉瘤的基础上组织考试，其次是分子分析。放射性和临床研究结果进行了审查。结果： CT显示明确的软组织肿块无皮质骨侵蚀和入侵。钙化是看到周围的群众在三个案件。 T2加权MR图像显示多大规模不均匀强度在所有案件中，其中5个显示流体流体水平。总值出现，旧的和/或新鲜血肿发现6例。在剩余的情况下，微观出血囊性流明证明。 4起案件已低分化地区。在5起案件突出hemangiopericytomatous血管观察。组织学分级是中间的一个肿瘤，高六。一个案件有一个历史的误诊跗管综合征，一个淋巴结，两项坐骨神经痛，两个血肿。结论：所有的囊性滑膜肉瘤表明multilocularity良好的限制墙壁和内部septae 。滑膜肉瘤，应考虑到患者深感位于三重multicystic质量与信号强度在T2加权成像。

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OBJECTIVE: The purpose of this study was to evaluate the lifetime evolution of the radioclinical features in a large family with van Buchem disease. DESIGN AND PATIENTS: The study population included 13 patients, ranging between 6 and 69 years. The evolution of the clinical features has been assessed by retrospective analysis of the clinical records of the patients. The age-related evolution of the cortical hyperostosis and defective modeling at the tubular bones was evaluated by morphometric analysis of hand films in 9 patients, compared with 9 control individuals. Progression of sclerosis of the craniofacial bones was evaluated by analysis of the skull radiographs of eleven van Buchem patients, taken at different age. RESULTS AND CONCLUSIONS: Radioclinical features, including sclerosis of the cranial and tubular bones and cranial nerve deficit, become more prominent in older patients. Defective modeling of tubular bones, cortical thickness and medullary width progress with age. Radioclinical abnormalities of van Buchem patients become more prominent in older patients, which suggests that the van Buchem gene is very actively involved in bone metabolism throughout life. Morphometric analysis of the plain films supports the hypothesis that the physiological function of the van Buchem gene is to inhibit bone formation and possibly to regulate bone remodeling.

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目的：本研究的目的是评估寿命演变radioclinical功能大家庭与Van Buchem疾病。设计与患者：研究人口包括13例，包括6至69岁。演变的临床特征已分摊的回顾性分析临床记录患者。年龄相关演变皮质增生和有缺陷的模型上进行了评价管状骨的形态分析，另一方面电影9例，与9控制个人。硬化进展的颅面骨骼的评价分析颅骨X光片的11万Buchem患者，采取不同的年龄。结果和结论： Radioclinical功能，包括硬化的头颅和管状骨和脑神经赤字，更加突出的老年患者。有缺陷的建模管状骨，皮质髓质厚度和宽度的进展与年龄。 Radioclinical异常患者的面包车Buchem更加突出的老年患者，这表明面包车Buchem基因是非常积极地参与骨代谢的整个生活。形态分析平片支持这一假设的生理功能的面包车Buchem基因抑制骨形成，并可能调节骨重建。

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Plexiform schwannoma of the forearm.

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We report a case of plexiform schwannoma located in the flexor muscles of the forearm in the absence of other signs of neurofibromatosis or schwannomatosis. Magnetic resonance examination revealed a multinodular irregular inhomogeneous mass. Some nodules displayed a peripheral, high intensity rim and a central low intensity (target sign) on T2-weighted images. Pre-operative diagnosis of the rare plexiform schwannoma may be possible with careful imaging examination for the target sign.

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我们报告一例丛状神经鞘瘤位于屈前臂肌肉在没有其他迹象神经或schwannomatosis 。磁共振检查发现multinodular不规则不均匀质量。有些结节周边显示，高强度RIM和中央低强度（靶征）在T2加权图像。术前诊断罕见丛状神经鞘瘤可能与仔细影像学检查为目标的迹象。

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Osteocartilaginous metaplasia is known to occur rarely in melanomas, particularly in subungual melanomas. We present a case of a calcified subungual soft tissue tumour in which biopsy of the lesion showed malignant round and spindle-shaped tumour cells, many of which were associated with the formation of cartilage and osteoid-like material. Subsequent resection showed clear histological evidence of a subungual melanoma. Tumour cells expressed S100, melan-A and neurone-specific enolase but were negative for HMB45. Diagnostic radiological and histological features and the nature of the osteocartilaginous differentiation within this lesion is discussed.

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Osteocartilaginous化生已知会发生罕见的黑色素瘤，尤其是在甲黑素瘤。本病例的钙化甲软组织肿瘤的活检的病灶显示恶性轮和梭形肿瘤细胞，其中许多是与形成软骨和骨类材料。随后切除明显组织学的证据表明，甲下黑色素瘤。肿瘤细胞表达9000 ，黑色素- A和神经元特异性烯醇化酶，但阴性HMB45 。诊断放射学和组织学特征和性质，在这个osteocartilaginous分化病变进行了讨论。

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Duplication of the scapula.

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Only three cases of scapular duplication have been described in English in the literature. We report a case of a child with duplication of the right scapula, operated on at our center with good results.

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只有3例肩胛重复描述了英语文学。我们报告一例重复儿童的权利肩胛骨，手术在我们中心收到了良好效果。

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