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Related Experiment Video

Updated: Dec 22, 2025

Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
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MRI Signal Intensity and Electron Ultrastructure Classification Predict the Long-Term Outcome of Skull Base

J Bai1,2,3, J Shi4, S Zhang2,5

  • 1From the Department of Neurosurgery (J.B., P.Z., S. Geng, S. Gui, Y. Zhang), Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

AJNR. American Journal of Neuroradiology
|May 9, 2020
PubMed
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MR imaging signal intensity can predict chordoma subtypes and prognosis. Lower T2 signal intensity ratios indicate cell-dense chordomas, which have poorer survival outcomes compared to matrix-rich types.

Area of Science:

  • Radiology
  • Oncology
  • Pathology

Background:

  • Chordomas are classified into cell-dense and matrix-rich types based on ultrastructural features.
  • The relationship between MR imaging signal intensity and these ultrastructural classifications was previously unknown.

Purpose of the Study:

  • To investigate if MR imaging signal intensity can predict chordoma ultrastructural classification.
  • To determine if MR imaging signal intensity is associated with patient prognosis.

Main Methods:

  • Retrospective analysis of 79 patients with skull base chordomas.
  • Calculation of preoperative tumor-to-pons MR imaging signal intensity ratios (RT1, RT2, REN).
  • Assessment of relationships between signal intensity ratios, ultrastructural classification, and survival outcomes.

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Last Updated: Dec 22, 2025

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Main Results:

  • Cell-dense chordomas exhibited lower RT2 compared to matrix-rich types (P < .001).
  • RT2 accurately predicted cell-dense type with an AUC of 0.83.
  • Matrix-rich chordomas showed significantly longer progression-free and overall survival than cell-dense types in patients not receiving radiation therapy.
  • REN was a risk factor for progression-free and overall survival, while RT2 was protective for overall survival.

Conclusions:

  • MR imaging signal intensity differences in chordomas correlate with their electron microscopic features.
  • Both MR imaging signal intensity ratios and electron microscopic features serve as potential prognostic factors for chordoma patients.