The imaging diagnosis of osteosarcomatosis

Objective: To analyze the imaging findings of osteosarcomatosis, and to explore the value of imaging in the diagnosis of osteosarcomatosis. Methods: Clinical data and imaging findings in 15 cases of osteosarcomatosis were reviewed. All of them had conventional X-ray films, 13 cases had CT scanning, 11 cases had ECT scanning, 5 cases had MR scanning, and 4 cases with DSA. Results: Eight primary lesions were located in the distal femur, 5 in the proximal tibia, 1 in humerus, and 1 in clavicle. Secondary lesions were scattered in proximal tibia in 8, distal femur in 6, spine in 6, pelvis in 2, and other sites. The primary lesion showed typical X-ray finding of osteosarcoma, but lesions at other position showed mainly high density of osteogenesis in all 15 cases. In 13 cases, CT played an important role in defining the extent of the tumor and soft tissue masses. CT scanning was sensitive in detecting osteosclerotic lesions in the bone marrow. In 5 cases, MRI was useful in delineating the extent of tumor and soft tissues mass, as well as the extent of tumor in bone marrow. ECT had the capacity of showing the radionuclide concentration of tumor focus in the whole body in a single scan in 11 patients. Conclusion: Osteosarcomatosis has multiple lesions all over the body. Imaging modalities including X-ray plain film, CT, MRI, and ECT are all important in finding the lesions and in diagnosing osteosarcomatosis. (author)