Abstract：Objective: To characterize the imaging spectrum of chordoma in the junction of craniocervical spine and mobile spine, so that to improve the understanding of chordoma. Methods: Fifty-five patients pathologically diagnosed with chordoma were reviewed and the following radiologic findings were evaluated including location, type of bone destruction, paraspinal and intraspinal invasion. Imaging appearances were summarized and compared with pathology results. Results: Cervical spine, the junction of cranial and lumbar spine was involved accounting for 76%, 16% and 7% respectively. Forty-six tumors were intraosseous, five cases were intraspinal and four cases were in the perivetebral space. Bone destruction was seen in vertebral body(45%), both vertebral body and posterior attachement(27%), clivus basilaris and C1(16%), and posterior attachement(2%). Thirty-two cases showed bone destruction and osteosclerosis and 5 cases showed no bone destruction. Chordomas tended to extend multilevel segments(62%) and invaded paraspinal and intraspinal space(87%) with enlargement of intervertebral foramen(22%) and showed dumb-bell shape(11%). Typital chordoma was commonly seen accounting for 95% and the rest(5%) was undifferentied and chondroid. Conclusions: Chordoma of mobile spine is commonly seen in the cervical spine and it often involves several spinal segments. Vertebral chordoma shows lytic bone destruction with bone sclerosis and it can invade paraspinal and intraspinal region and very few cases may be in the intraspinal and paraspinal region with foramen enlargement. Dumb-belled chordoma and chordoma without bone destruction are less commonly seen.
张立华，袁慧书. 颅颈交界区及可动脊柱脊索瘤的影像表现分析[J]. 中国临床医学影像杂志, 2018, 29(1): 4-7.
ZHANG Li-hua, YUAN Hui-shu. Imaging analysis of chordoma in craniocervical junction and mobile spine. JOURNAL OF CHINA MEDICAL IMAGING, 2018, 29(1): 4-7.
[1]Walcott BP, Nahed BV, Mohyeldin A, et al. Chordoma: current concepts, management, and future directions[J]. Lancet Oncol, 2012, 13(2): e69-76.
[2]Rena O, Davoli F, Allegra G, et al. Giant Chordoma of the Upper Thoracic Spine with Mediastinal Involvement: A Surgical Challenge[J]. Asian Spine J, 2014, 8(3): 353-356.
[3]Alotaibi F, Guiot MC, Muanza T, et al. Giant Petroclival Primary Intradural Chordoma: Case Report and Systematic Review of the Literature[J]. J Neurol Surg Rep, 2014, 75(1): e160-e169.
[4]Radzikowska J, Gronkiewicz Z, Kukwa A, et al. Nasopharyngeal chordoma in a patient with a severe form of sleep-disordered breathing: A case report[J]. Oncol Lett, 2015, 10(3): 1805-1809.
[5]Ridenour III RV, Ahrens WA, Folpe AL, et al. Clinical and Histopathologic Features of Chordomas in Children and Young Adults[J]. Pediatr Dev Pathol, 2010, 13(1): 9-17.
[6]Liang J, Liu ZJ, Liu XG, et al. Upper cervical spine chordoma of C2~C3[J]. Eur Spine J, 2009, 18(3): 293-300.
[7]Kim KH. Intradural Clival Chordoma: A Case Report[J]. Brain Tumor Res Treat, 2014, 2(2): 76-80.
[8]Diel J, Ortiz O, Losada RA, et al. The sacrum: pathologic spectrum, multimodality imaging, and subspecialty approach[J]. Radiographics, 2001, 21(1): 83-100.
[9]王冬梅，孙琦，杨献峰，等. 脊索瘤的影像诊断及分期[J]. 中国临床医学影像杂志，2010，21（12）：863-866.
[10]Lantos JE, Agaram NP, Healey JH, et al. Recurrent skeletal extra-axial chordoma confirmed with brachyury: imaging features and review of the literature[J]. Skeletal Radiol, 2013, 42(10): 1451-1459.
[11]Kim SC, Cho W, Chang UK, et al. Two Cases of Dedifferentiated Chordoma in the Sacrum[J]. Korean J Spine, 2015, 12(3): 230-234.
[12]Momjian R, George M. Atypical Imaging Features of Tuberculous Spondylitis: Case Report with Literature Review[J]. J Radiol Case Rep, 2014, 8(11): 1-14.
[13]Kreshak J, Larousserie F, Picci P, et al. Difficulty distinguishing benign notochordal cell tumor from chordoma further suggests a link between them[J]. Cancer Imaging, 2014, 14(1): 4.
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