Tomokazu Nishiguchi,Kunizo Mochizuki, Masahiko Ohsawa, Takeshi Inoue, Ken Kageyama, Akinobu Suzuki, Toshihiro Takami, Yukio Miki
OBJECTIVE. The purpose of this study was to characterize the imaging spectrum of be-nign notochordal cell tumors (BNCTs) and chondromas and to determine if this helped in differentiating BNCTs from chordomas.
MATERIALS AND METHODS. Thirty-eight patients pathologically diagnosed with chordomas were reviewed and ultimately diagnosed to have five BNCTs and 33 chordomas. The following radiologic findings were reevaluated by two radiologists by consensus: extraosseous extension, osseous change on CT or conventional tomography, T2-weighted MR signal intensity, T2-weighted signal homogeneity, and contrast-enhanced Tl-weighted MR signal intensity. Fisher's exact test was performed to determine statistical significance.
RESULTS. Our study yielded five results. First, four of five BNCTs (80%) were intraosseous, whereas 31 of 33 chordomas (94%) were both intra- and extraosseous (p < 0.0001). Second, all BNCTs showed mild osteosclerosis without bone destruction; all chordomas showed variable osteolysis (p = 0.0092). Third, all BNCTs and 28 of 33 chordomas (85%) showed hyperintensity on T2-weighted images (p > 0.05). Fourth, four of five BNCTs (80%) and 27 of 33 chordomas (82%) were heterogeneous on T2-weighted images (p > 0.05). Fifth, no BNCTs enhanced, whereas all chordomas variably enhanced (p < 0.0001).
CONCLUSION. Radiologic studies may allow distinction of BNCTs from chordomas.