“…Lipoma and lipomatous variants are the most frequent benign STT, with prevalence ranging between 16% and 50% [ 1 – 4 ]. Most of the benign lesions are located in the subcutaneous compartment of the superficial soft tissues [ 3 , 5 ]. Although liposarcoma is the second most frequent malignant STT (14.2%) after myxofibrosarcoma, formerly named myxoid malignant fibrous histiocytoma [ 6 ], it is rather uncommon in the subcutaneous compartment [ 4 ].…”
ObjectiveTo retrospectively analyse the magnetic resonance (MR) findings of subcutaneous lipomatous soft-tissue tumours (SLSTT) in order to define a diagnostic and therapeutic strategy.MethodsThe MR findings of 46 SLSTT were registered for the following data: area, location within the subcutaneous compartment, dimensions, shape and delineation, signal intensity (SI) on different pulse sequences, signal homogeneity, degree and pattern of contrast enhancement. The MR findings, together with patients' age and gender, were compared with histopathological findings.ResultsSixty-eight percent of the lipomas had a homogeneous T1-SI identical to the SI of subcutaneous fat. Heterogeneity in other lipomas was due to fat necrosis and small septa. Other lesions with homogeneous T1-SI identical to the SI of subcutaneous fat included lipoblastoma, lipomatosis and lipoma-like hibernoma. None of the liposarcomas were homogeneous and isointense to SI of subcutaneous fat on T1-weighted imaging (WI). Lipoma variants and liposarcomas showed overlapping MR characteristics.ConclusionsSLSTT with homogeneous T1-SI identical to the SI of subcutaneous fat are benign. If a SLSTT has other MR characteristics, differentiation based on MRI cannot be made and biopsy is needed. We used this finding in defining a diagnostic and therapeutic strategy for subcutaneous soft tissue tumours that are hyperintense on T1-WI.
“…Lipoma and lipomatous variants are the most frequent benign STT, with prevalence ranging between 16% and 50% [ 1 – 4 ]. Most of the benign lesions are located in the subcutaneous compartment of the superficial soft tissues [ 3 , 5 ]. Although liposarcoma is the second most frequent malignant STT (14.2%) after myxofibrosarcoma, formerly named myxoid malignant fibrous histiocytoma [ 6 ], it is rather uncommon in the subcutaneous compartment [ 4 ].…”
ObjectiveTo retrospectively analyse the magnetic resonance (MR) findings of subcutaneous lipomatous soft-tissue tumours (SLSTT) in order to define a diagnostic and therapeutic strategy.MethodsThe MR findings of 46 SLSTT were registered for the following data: area, location within the subcutaneous compartment, dimensions, shape and delineation, signal intensity (SI) on different pulse sequences, signal homogeneity, degree and pattern of contrast enhancement. The MR findings, together with patients' age and gender, were compared with histopathological findings.ResultsSixty-eight percent of the lipomas had a homogeneous T1-SI identical to the SI of subcutaneous fat. Heterogeneity in other lipomas was due to fat necrosis and small septa. Other lesions with homogeneous T1-SI identical to the SI of subcutaneous fat included lipoblastoma, lipomatosis and lipoma-like hibernoma. None of the liposarcomas were homogeneous and isointense to SI of subcutaneous fat on T1-weighted imaging (WI). Lipoma variants and liposarcomas showed overlapping MR characteristics.ConclusionsSLSTT with homogeneous T1-SI identical to the SI of subcutaneous fat are benign. If a SLSTT has other MR characteristics, differentiation based on MRI cannot be made and biopsy is needed. We used this finding in defining a diagnostic and therapeutic strategy for subcutaneous soft tissue tumours that are hyperintense on T1-WI.
“…If there is any suspicion of a malignant lesion, intravenous administration of gadolinium contrast should be performed. True cystic lesions will only show minor peripheral rim enhancement, whereas a heterogeneous enhancement pattern is seen in myxoid or malignant tumours with cystic areas [44]. Fig.…”
Section: Spectrum Of Pathologic Conditionsmentioning
BackgroundPeroneal nerve lesions are not common and are often exclusively assessed clinically and electromyographically.MethodsOn a routine MR examination without dedicated MR-neurography sequences the peroneal nerve can readily be assessed. Axial T1-weighted sequences are especially helpful as they allow a good differentiation between the nerve and the surrounding fat.ResultsThe purpose of this article is to review the normal anatomy and pathologic conditions of the peroneal nerve around the knee.ConclusionIn the first part the variable anatomy of the peroneal nerve around the knee will be emphasized, followed by a discussion of the clinical findings of peroneal neuropathy and general MR signs of denervation. Six anatomical features may predispose to peroneal neuropathy: paucity of epineural tissue, biceps femoris tunnel, bifurcation level, superficial course around the fibula, fibular tunnel and finally the additional nerve branches. In the second part we discuss the different pathologic conditions: accidental and surgical trauma, and intraneural and extraneural compressive lesions.Teaching Points• Six anatomical features contribute to the vulnerability of the peroneal nerve around the knee.• MR signs of muscle denervation within the anterior compartment are important secondary signs for evaluation of the peroneal nerve.• The most common lesions of the peroneal nerve are traumatic or compressive.• Intraneural ganglia originate from the proximal tibiofibular joint.• Axial T1-weighted images are the best sequence to visualise the peroneal nerve on routine MRI.
The objective of this review is to highlight the major imaging characteristics of the main soft-tissue sarcoma histotypes observed in the group "Sarcomi" of the Istituto Oncologico Veneto in the last 5 years. A literature review was performed using PubMed and textbooks. Radiological imaging can guide the diagnosis for the subset of lesions that have typical clinical and imaging features. Soft-tissue tumors are common in clinical practice and a systematic clinical and imaging approach may guide the diagnosis.
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