MR imaging in the follow-up of malignant and aggressive soft-tissue tumors: results of 511 examinations.

Abstract

To present magnetic resonance (MR) imaging findings from 511 follow-up examinations of aggressive soft-tissue tumors. One hundred eighty-two patients with aggressive soft-tissue tumours underwent postoperative T1- and T2-weighted imaging; 41 also underwent 51 gadolinium-enhanced T1-weighted examinations, and five underwent dynamic gadolinium-enhanced subtraction imaging. Twenty-four of 25 patients (101 of 102 examinations) without high signal intensity (HSI) at T2-weighted imaging had no recurrence. Among 79 patients (321 examinations) who demonstrated HSI without a mass, only two tumors recurred within 1 year. An HSI mass was found in 88 studies of 78 patients and represented recurrence (n = 60), hygroma (n = 24), or a radiation-induced pseudomass (n = 4). Hygromas did not enhance, while recurrences enhanced at 1-3 minutes and postirradiation change enhanced at 4-7 minutes. T2-weighted imaging can be used to identify possible recurrence of aggressive soft-tissue tumors, while gadolinium-enhanced imaging can be used to differentiate recurrences from hygromas and inflammatory change.