scholarly journals Simple Stepwise Approach to Differentiate Cyst-Like Soft-Tissue Masses by Using Time-Resolved Magnetic Resonance Angiography

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1094
Author(s):  
Ying-Chieh Lai ◽  
Yu-Hsiang Juan ◽  
Shu-Hang Ng ◽  
Tzu-Chin Lo ◽  
Wen-Yu Chuang ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Magnetic Resonance Angiography ◽  
Odds Ratio ◽  
Vascular Lesions ◽  
Time Resolved ◽  
Occult Lesion ◽  
Soft Tissue Masses ◽  
Diagnostic Flowchart ◽  
The Masses ◽  
Solid Lesions

This retrospective study aimed to differentiate cyst-like musculoskeletal soft-tissue masses by using time-resolved magnetic resonance angiography (MRA). During May 2015 to November 2019, patients with cyst-like soft-tissue masses examined through contrast-enhanced MRI followed by histologic diagnosis were included. The masses were classified into vascular lesions, solid lesions, and true cysts. Size, T1 hyperintensity, T2 composition, perilesional edema, time-resolved MRA, and static internal enhancement were assessed. The time-resolved MRA manifestations were classified into vascular pooling, solid stain, and occult lesion. Imaging predictors for each type of mass were identified through logistic regression and were used to develop a diagnostic flowchart. A total of 80 patients (47 men; median age, 42 years) were included, with 22 vascular lesions, 38 solid lesions, and 20 true cysts. The T2 composition, time-resolved MRA, and static internal enhancement were significantly different among the masses. Vascular pooling on time-resolved MRA was the sole predictor of vascular lesions (odds ratio = 722.0, p < 0.001). Solid stain on time-resolved MRA was the sole predictor of solid lesions (odds ratio = 73.6, p < 0.001). Occult lesion on time-resolved MRA (odds ratio = 7.4, p = 0.001) and absence of static internal enhancement (odds ratio = 80.0, p < 0.001) both predicted true cysts, while the latter was the sole predictor of true cysts after multivariate analysis. A diagnostic flowchart based on time-resolved MRA correctly classified 89% of the masses. In conclusion, time-resolved MRA accurately differentiates cyst-like soft-tissue masses and provides guidance for management.

Time-Resolved Magnetic Resonance Angiography in the Evaluation of Intracranial Vascular Lesions and Tumors: A Pictorial Essay of Our Experience

2015 ◽  
Vol 66 (4) ◽  
pp. 385-392 ◽  
Author(s):  
Ming-Cheng Liu ◽  
Hung-Chieh Chen ◽  
Chen-Hao Wu ◽  
Wen-Hsien Chen ◽  
Yuang-Seng Tsuei ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Computed Tomographic Angiography ◽  
Frame Rate ◽  
Vascular Lesions ◽  
Invasive Technique ◽  
Time Resolved ◽  
Acceleration Techniques ◽  
Pictorial Essay ◽  
Hypervascular Tumors

Time-resolved magnetic resonance angiography (TR MRA) is a promising less invasive technique for the diagnosis of intracranial vascular lesions and hypervascular tumors. Similar to 4-dimensional computed tomographic angiography obtaining high frame rate images, TR MRA utilizes acceleration techniques to acquire sequential arterial and venous phase images for identifying, localizing, and classifying vascular lesions. Because of the good agreement with digital subtraction angiography for grading brain arteriovenous malformations with the Spetzler–Martin classification and the good sensitivity for visualizing arteriovenous fistulas, studies have suggested that TR MRA could serve as a screening or routine follow-up tool for diagnosing intracranial vascular disorders. In this pictorial essay, we report on the use of TR MRA at 3.0 T to diagnose intracranial vascular lesions and hypervascular tumors, employing DSA as the reference technique.

scholarly journals The Clinical and Radiological Characteristics of Inflammatory Myofibroblastic Tumor Occurring at Unusual Sites

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Xuewei Zeng ◽  
Huayi Huang ◽  
Jun Li ◽  
Jiayou Peng ◽  
Jiaxiong Zhang
Keyword(s):  
Soft Tissue ◽  
Inflammatory Myofibroblastic Tumor ◽  
Soft Tissues ◽  
Malignant Tumors ◽  
Bladder Wall ◽  
Benign Tumors ◽  
Mri Scans ◽  
Soft Tissue Masses ◽  
The Masses ◽  
Radiological Methods

Inflammatory myofibroblastic tumor (IMT) can occur rarely in the soft tissue or joint of the limb. We retrospectively collected IMT cases of these rare sites and analyzed their clinical and imaging appearance. Thirteen cases of IMT were clinically diagnosed and underwent surgical procedures, pathological analyses, and postsurgical follow-up in our two hospitals. Other than one case of IMT of the bladder wall that presented with gross hematuria, none presented with local swelling, fever, or weakness. All the cases of IMT occurring at the bone showed destruction and parosteal soft tissue masses. The boundaries between the mass and normal bone were vague, without calcifications or any periosteal reaction. Five cases of IMF showed continuous enhancement on CT; seven cases demonstrated iso- or hyposignal intensity on T1WI; one case showed hypersignal intensity on T1WI, and eight cases demonstrated a hypersignal intensity signal on T2WI. All the masses located in soft tissues showed clear and sharp boundaries with different sizes of the swelling regions surrounding muscle interspaces. Three cases showed homogeneous enhancement, one case demonstrated heterogeneous enhancement, and two cases showed edge enhancement on enhanced MRI scans. On pathology, all the lesions showed an absence of a pseudocapsule, and four cases of ALK were positive. The radiological manifestations of IMT located at the soft tissue and bones were similar to benign tumors in shape; however, peritumoral edema, parosteal soft tissue, and the invasive rim of IMT are similar to the features of malignant tumors. Different radiological methods should be used to obtain an accurate diagnosis.

Soft tissue enhancement on time-resolved peripheral magnetic resonance angiography

2004 ◽  
Vol 19 (5) ◽  
pp. 590-597 ◽  
Author(s):  
Hong Lei Zhang ◽  
K. Craig Kent ◽  
Harry L. Bush ◽  
Priscilla A. Winchester ◽  
Richard Watts ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Soft Tissue ◽  
Magnetic Resonance Angiography ◽  
Time Resolved ◽  
Tissue Enhancement

Combined Therapy for Vascular Lesions of the Head and Neck with Intra-Arterial Embolization and Surgical Excision

1982 ◽  
Vol 90 (1) ◽  
pp. 37-47 ◽  
Author(s):  
Hugh F. Biller ◽  
Yosef P. Krespi ◽  
Peter M. Som
Keyword(s):  
Soft Tissue ◽  
Arteriovenous Malformations ◽  
Combined Therapy ◽  
Arterial Embolization ◽  
Surgical Excision ◽  
Vascular Lesions ◽  
Tumor Site ◽  
Carotid Angiography ◽  
Selective Angiography ◽  
Soft Tissue Masses

Large extracranial arteriovenous malformations (AVM) are considered rare. Most of these lesions appear as soft tissue masses or as bleeding. Symptoms relate to the tumor site. The clinical diagnosis of AVM should be confirmed by selective angiography. The preferred technique for carotid angiography is selective catheterization by the retrograde femoral approach based on Seldinger's method.

scholarly journals Soft tissue masses: distribution of entities and rate of malignancy in small lesions

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Felix G. Gassert ◽  
Florian T. Gassert ◽  
Katja Specht ◽  
Carolin Knebel ◽  
Ulrich Lenze ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Benign Lesion ◽  
Maximum Diameter ◽  
Histopathological Diagnosis ◽  
Tumor Diameter ◽  
Mr Images ◽  
Tissue Mass ◽  
Malignancy Rate ◽  
Significant Difference ◽  
Soft Tissue Masses

Abstract Background Small soft tissue masses are often falsely assumed to be benign and resected with failure to achieve tumor-free margins. Therefore, this study retrospectively investigated the distribution of histopathologic diagnosis to be encountered in small soft tissue tumors (≤ 5 cm) in a large series of a tertiary referral center. Methods Patients with a soft tissue mass (STM) with a maximum diameter of 5 cm presenting at our institution over a period of 10 years, who had undergone preoperative Magnetic resonance imaging and consequent biopsy or/and surgical resection, were included in this study. A final histopathological diagnosis was available in all cases. The maximum tumor diameter was determined on MR images by one radiologist. Moreover, tumor localization (head/neck, trunk, upper extremity, lower extremity, hand, foot) and depth (superficial / deep to fascia) were assessed. Results In total, histopathologic results and MR images of 1753 patients were reviewed. Eight hundred seventy patients (49.63%) showed a STM ≤ 5 cm and were therefore included in this study (46.79 +/− 18.08 years, 464 women). Mean maximum diameter of the assessed STMs was 2.88 cm. Of 870 analyzed lesions ≤ 5 cm, 170 (19.54%) were classified as superficial and 700 (80.46%) as deep. The malignancy rate of all lesions ≤ 5 cm was at 22.41% (superficial: 23.53% / deep: 22.14%). The malignancy rate dropped to 16.49% (20.79% / 15.32%) when assessing lesions ≤ 3 cm (p = 0.007) and to 15.0% (18.18% / 13.79%) when assessing lesions ≤ 2 cm (p = 0.006). Overall, lipoma was the most common benign lesion of superficial STMs (29.41%) and tenosynovial giant cell tumor was the most common benign lesion of deep STMs (23.29%). Undifferentiated pleomorphic sarcoma was the most common malignant diagnosis among both, superficial (5.29%) and deep (3.57%) STMs. Conclusions The rate of malignancy decreased significantly with tumor size in both, superficial and deep STMs. The distribution of entities was different between superficial and deep STMs, yet there was no significant difference found in the malignancy rate.

scholarly journals Musculoskeletal Soft-Tissue Sarcoma: Quality Assessment of Initial MRI Reports Shows Frequent Deviation from ESSR Guidelines

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 695
Author(s):  
Sebastian Weiss ◽  
Alexander Korthaus ◽  
Nora Baumann ◽  
Jin Yamamura ◽  
Alexander S. Spiro ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcomas ◽  
Quality Criteria ◽  
Final Diagnosis ◽  
Tissue Mass ◽  
Musculoskeletal Radiology ◽  
Radiology Reports ◽  
Patients At Risk ◽  
Magnetic Resonance Imaging Mri ◽  
The Masses

Soft-tissue sarcomas (STS) are a rare subtype of soft-tissue mass and are frequently misinterpreted as benign lesions. Magnetic resonance imaging (MRI) is the primary recommended type of diagnostics. To assess the quality of primary radiology reports, we investigated whether recommended MRI report elements were included in compliance with European Society of Musculoskeletal Radiology (ESSR) guidelines. A total of 1107 patients were evaluated retrospectively, and 126 radiological reports on patients with malignant STS were assessed for ESSR quality criteria. One or more required sequences or planes were missing in 67% of the reports. In all 126 cases, the report recognized the mass as anomalous (100%). Sixty-eight percent of the reports mentioned signs of malignancy. The majority of reports (n = 109, 87%) articulated a suspected diagnosis, 32 of which showed a mismatch with the final diagnosis (25%). Thirty-two percent of the reports had a misinterpretation of the masses as benign. Benign misinterpretations were more common in masses smaller than 5 cm (65% vs. 27%). Thirty percent of the reports suggested tissue biopsy and 6% recommended referral to a sarcoma center. MRI reports showed frequent deviations from ESSR guidelines, and protocol guidelines were not routinely met. Deviations from standard protocol and reporting guidelines could put patients at risk for inadequate therapy.

Predicting in Vivo Soft Tissue Masses of the Lower Extremity Using Segment Anthropometric Measures and DXA

2005 ◽  
Vol 21 (4) ◽  
pp. 371-382 ◽  
Author(s):  
Jeffrey D. Holmes ◽  
David M. Andrews ◽  
Jennifer L. Durkin ◽  
James J. Dowling
Keyword(s):  
Soft Tissue ◽  
Lower Extremity ◽  
Prediction Equation ◽  
Regression Equations ◽  
Anthropometric Measures ◽  
Soft Tissue Masses ◽  
Highly Correlated ◽  
Relative Errors ◽  
Dxa Scans

The purpose of this study was to derive and validate regression equations for the prediction of fat mass (FM), lean mass (LM), wobbling mass (WM), and bone mineral content (BMC) of the thigh, leg, and leg + foot segments of living people from easily measured segmental anthropometric measures. The segment masses of 68 university-age participants (26 M, 42 F) were obtained from full-body dual photon x-ray absorptiometry (DXA) scans, and were used as the criterion values against which predicted masses were compared. Comprehensive anthropometric measures (6 lengths, 6 circumferences, 8 breadths, 4 skinfolds) were taken bilaterally for the thigh and leg for each person. Stepwise multiple linear regression was used to derive a prediction equation for each mass type and segment. Prediction equations exhibited high adjustedR2values in general (0.673 to 0.925), with higher correlations evident for the LM and WM equations than for FM and BMC. Predicted (equations) and measured (DXA) segment LM and WM were also found to be highly correlated (R2= 0.85 to 0.96), and FM and BMC to a lesser extent (R2= 0.49 to 0.78). Relative errors between predicted and measured masses ranged between 0.7% and –11.3% for all those in the validation sample (n= 16). These results on university-age men and women are encouraging and suggest that in vivo estimates of the soft tissue masses of the lower extremity can be made fairly accurately from simple segmental anthropometric measures.

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