SOFT TISSUE arises from the mesenchyme, which during development differentiates into fat, skeletal muscles, peripheral nerves, blood vessels, and fibrous tissue (1). Soft-tissue tumors are histologically classified on the basis of the soft-tissue component that presents the lesion, but this does not imply that the tumor develops from that tissue (1). Although imaging cannot always be used to characterize soft-tissue lesion, clinical history (ie, information about recent traumas, fluctuating mass size, malignancies or familial syndromes) and physical examination (ie, superficial/deep mass, fixity to surrounding tissue) can help identify lesions that need biopsy to exclude malignancy (2). Wu and Hochman (2) report the basic sequences employed to evaluate a soft-tissue mass; we usually refer to the sequences reported in Table 1. Soft-tissue sarcomas are generally larger than 5 cm and more likely to outgrow their vascular supply with subsequent infarction and necrosis and heterogeneous signal intensity on T2-weighted (T2w) images (3). They respect fascial borders and remain within anatomic compartments without infiltrating adjacent structures until late in their development (3,4). Computed tomography (CT) and magnetic resonance imaging (MRI) are the current state of art in the proper staging, evaluation of locoregional involvement, presence of necrotic areas, infiltration and surrounding tissue, and surgical and bioptical planning (5–8). Since distant dissemination principally involves lungs, liver, and bone, CT of the abdomen and the chest is necessary to evaluate for retroperitoneal lymphadenopathy and metastasis: CT is more sensitive in the detection of bone cortical thinning and cortical invasion, while MRI is useful to evaluate compartmentality, intraarticular tumor extension, and for the depiction of bone marrow edema (5–9). Our group has undertaken a review of some of the almost 200 cases of soft-tissue lesions that we have diagnosed in the last 5 years and that have been collected in the MIRC database (10). A literature review was performed using PubMed as well as cited references within previously published articles and textbooks for all published studies related to imaging of soft-tissue tumors, with particular attention to ultrasonography (US) and MRI findings.

Imaging of soft-tissue tumors.

STRAMARE, ROBERTO;BELTRAME, VALERIA;FACCINETTO, ALESSANDRO;RASTRELLI, MARCO;ROSSI, CARLO
2012

Abstract

SOFT TISSUE arises from the mesenchyme, which during development differentiates into fat, skeletal muscles, peripheral nerves, blood vessels, and fibrous tissue (1). Soft-tissue tumors are histologically classified on the basis of the soft-tissue component that presents the lesion, but this does not imply that the tumor develops from that tissue (1). Although imaging cannot always be used to characterize soft-tissue lesion, clinical history (ie, information about recent traumas, fluctuating mass size, malignancies or familial syndromes) and physical examination (ie, superficial/deep mass, fixity to surrounding tissue) can help identify lesions that need biopsy to exclude malignancy (2). Wu and Hochman (2) report the basic sequences employed to evaluate a soft-tissue mass; we usually refer to the sequences reported in Table 1. Soft-tissue sarcomas are generally larger than 5 cm and more likely to outgrow their vascular supply with subsequent infarction and necrosis and heterogeneous signal intensity on T2-weighted (T2w) images (3). They respect fascial borders and remain within anatomic compartments without infiltrating adjacent structures until late in their development (3,4). Computed tomography (CT) and magnetic resonance imaging (MRI) are the current state of art in the proper staging, evaluation of locoregional involvement, presence of necrotic areas, infiltration and surrounding tissue, and surgical and bioptical planning (5–8). Since distant dissemination principally involves lungs, liver, and bone, CT of the abdomen and the chest is necessary to evaluate for retroperitoneal lymphadenopathy and metastasis: CT is more sensitive in the detection of bone cortical thinning and cortical invasion, while MRI is useful to evaluate compartmentality, intraarticular tumor extension, and for the depiction of bone marrow edema (5–9). Our group has undertaken a review of some of the almost 200 cases of soft-tissue lesions that we have diagnosed in the last 5 years and that have been collected in the MIRC database (10). A literature review was performed using PubMed as well as cited references within previously published articles and textbooks for all published studies related to imaging of soft-tissue tumors, with particular attention to ultrasonography (US) and MRI findings.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11577/2530034
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