Diabetic muscle infarction is suggested in diabetic patients with sudden onset of severe pain in the thigh or calf muscles who have MR imaging findings of diffuse edema and swelling of multiple thigh and calf muscles (often in more than one compartment).
The findings on images of liposarcomas of the extremities in 48 patients (26 men and 22 women aged 20-85 years) were reviewed to correlate the histologic subtypes with radiologic appearance. Computed tomographic scans were obtained in 36 patients; magnetic resonance (MR) images, in 27 patients. The study group had 19 myxoid, 12 well-differentiated, nine round cell, and eight pleomorphic liposarcomas. Well-differentiated liposarcomas were predominantly composed of fat, typically with thick septa, which were hyperintense on T2-weighted spin-echo MR images. The heterogeneity of tumor helped differentiate tumor subtypes. Eleven of 19 myxoid tumors were mildly heterogeneous. Round cell and pleomorphic subtypes, which tend to be aggressive, were generally heterogeneous. Well-differentiated liposarcomas may be confidently differentiated from other subtypes of liposarcoma. Except for the well-differentiated subtypes, liposarcomas often contain no fat. Moderate to marked heterogeneity is common in high-grade liposarcomas; myxoid liposarcomas tend to be homogeneous and may mimic cysts.
Background. Radiologic tests to determine the size and location of cancer on peritoneal surfaces are needed for patient management and for clinical research activity.
Methods. Computed tomography (CT) of the abdomen and pelvis were obtained on 45 patients with a diagnosis of peritoneal carcinomatosis before implementation of a complete exploratory laparotomy with biopsy or resection of all tissues suspicious of malignancy. CT findings and surgical findings were recorded and the data analyzed by dividing the abdomen into 9 regions or into 15 anatomic sites.
Results. In an overall patient analysis, the sensitivity was 79%. In the nine different abdominal regions, sensitivity was greater than 80% in the right flank, left flank, and right lower and left lower abdominal regions. Sensitivity was lowest in the pelvis (60%). Negative predictive value in the pelvis was 20%. The volume of tumor present within an abdominal region or anatomic site greatly influenced the sensitivity. A sensitivity of only 28% was recorded when tumor nodules were less than 0.5 cm in thickness. This increased to 90% when nodule thickness was greater than 5 cm.
Conclusions. CT is not a reliable diagnostic test for low volume tumor on peritoneal surfaces, and the greatest inaccuracies were recorded in the pelvis. Its diagnostic value increased as tumor volume increased.
Percutaneous biopsy of primary bone tumors is safe and accurate for diagnosis and grade of specific tumor. In cases with nondiagnostic biopsy, open-procedure biopsy is likely to be associated with similar diagnostic difficulties.
CT and MR imaging findings of telangiectatic osteosarcoma often include thick nodular tissue (and matrix mineralization at CT) in a largely hemorrhagic and/or necrotic osseous lesion with an associated soft-tissue mass, which allows distinction from aneurysmal bone cyst.
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