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Skeletal Radiology

, Volume 34, Issue 2, pp 87–94 | Cite as

Sacrococcygeal chordoma: MR imaging in 30 patients

  • Mi Sook SungEmail author
  • Gyung Kyu Lee
  • Heung Sik Kang
  • Soon Tae Kwon
  • Jin Gyoon Park
  • Jin Suk Suh
  • Gil Ho Cho
  • Sung Moon Lee
  • Myung Hee Chung
  • Donald Resnick
Scientific Article

Abstract

Objective

To evaluate MR imaging of sacrococcygeal chordoma.

Design and patients

Thirty patients (age range 22–80 years) underwent MR imaging for the diagnosis and preoperative evaluation of sacrococcygeal chordomas. Eight patients had follow-up MR examination after treatment. The MR images were performed with T1- and T2-weighted imaging, and gadolinium (Gd)-enhanced imaging. The MR images were analyzed for the signal intensity, enhancing pattern, tumor size, growth pattern of the soft tissue component, and tumor extension.

Results and conclusions

T1-weighted images showed low signal masses with foci of high signal intensity in 73% of cases. Tumors enhanced in a variety of patterns after the administration of Gd. Soft tissue masses extending anteriorly were seen in all cases with posterior extension in 77% of cases. The posterior masses involved the surrounding muscles and extended toward the greater sciatic notch, appearing with pseudopodia (87%). Sacroiliac joints were involved in 23% of cases. Four lesions showed intraspinal extension and involvement of the posterior spinal muscles above the level of bony involvement. In 6 patients recurrent tumors were found at or around the surgical margin of the tumor 6 months to 5 years after resection of the sacral tumor. In two of the patients, nodular metastases to the pelvic bones and femur were found 1–4 years after initial examination. In conclusion, MR imaging is useful in the diagnosis and preoperative assessment of sacrococcygeal chordoma. Characteristic findings included sacral mass with heterogeneously high signal intensity with crisscrossing septa on long-repetition-time imaging, well-encapsulated pseudopodia-like or lobulated appearance, and gluteal muscle infiltration. Follow-up MR imaging is helpful to assess for recurrent or metastatic lesions of chordomas.

Keywords

Chordoma Sacrococcygeal MR imaging Recurrent tumor Metastasis 

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Copyright information

© ISS 2004

Authors and Affiliations

  • Mi Sook Sung
    • 1
    Email author
  • Gyung Kyu Lee
    • 2
  • Heung Sik Kang
    • 2
  • Soon Tae Kwon
    • 3
  • Jin Gyoon Park
    • 4
  • Jin Suk Suh
    • 5
  • Gil Ho Cho
    • 6
  • Sung Moon Lee
    • 7
  • Myung Hee Chung
    • 1
  • Donald Resnick
    • 8
  1. 1.Department of RadiologyThe Catholic University of Korea, Holy Family HospitalPucheon, Kyunggi-do 420-717Korea
  2. 2.Department of RadiologySeoul National University HospitalSeoulKorea
  3. 3.Department of RadiologyChungnam University HospitalTaejunKorea
  4. 4.Department of RadiologyChunnam University HospitalKwangjuKorea
  5. 5.Department of RadiologyYonsei University, Severans HospitalSeoulKorea
  6. 6.Department of RadiologyYeungnam University HospitalTaeguKorea
  7. 7.Department of RadiologyKaemyung University HospitalTaekuKorea
  8. 8.Department of RadiologyVA Medical CenterSan DiegoUSA

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