Abstract
Purpose: To evaluate contrast-enhanced magnetic resonance imaging (CE‑MRI) and diffusion-weighted (DWI) in the detection and differential diagnosis of recurrent of retroperitoneal liposarcomas with postoperative changes.Material and methods: The retrospective study included of 23 patients previously operated on for retroperitoneal inorganic liposarcomas. All patients underwent MRI of the abdominal cavity and pelvis with intravenous contrast with further assessment of the size, shape, structure and characteristics of the accumulation of contrast agent in the detected formation.Results: Morphological verification were performed in 17 patients (74 %), in 6 cases (26 %) patients were left for dynamic control for 1–3 years. Local relapses were detected in 16 patients (67 %), postoperative changes — in 7 (33 %) patients, of which in 2 cases deformation of adipose tissue and fibrotic changes in the area of surgery was determined, in 3 patients granulomas were revealed, and in two patients — volvulus of the greater omentum and lymphocele. The sensitivity of MRI with intravenous contrast enhancement was 68.7 %, specificity 71.4 % and accuracy 69.6 %. The addition of DWI to the standard MRI protocol in patients with suspected recurrence of retroperitoneal liposarcoma to increase the sensitivity of the method in the differential diagnosis of recurrent drugs from postoperative changes to 93.7 % (15 out of 16), specificity up to 100 % (7 out of 7) and accuracy up to 95.6 % (22 out of 23).Conclusion: The joint use of MRI with intravenous contrast and DW‑MRI increases the information content in the detection and differential diagnosis of small-sized recurrent tumors in dedifferentiated and myxoid types of liposarcomas with postoperative changes.
Highlights
The retrospective study included of 23 patients previously operated on
Morphological verification were performed in 17 patients
patients were left for dynamic control for 1–3 years
Summary
Примечания: ВЛС — высокодифференцированная ЛС, ДЛС — дедифференцированная ЛС, МЛС — миксоидная ЛС, п/о изменения — послеоперационные изменения. А — T2‐томограмма забрюшинно слева определяется гипоинтенсивное тяжистое уплотнение (стрелки); Б — T1‐томограмма (нативная фаза) — образование представляется изоинтенсивным (стрелки); В — артериальная фаза — однородное накопление контрастного препарата в образовании (стрелки); Г — отсроченная фаза — увеличение степени усиления контрастного препарата (стрелки); Д — ДВ‐МРТ (b = 400 с/мм2) — ограничение диффузии молекул воды не выявлено; Е — ИКД-карта: измеряемый коэффициент диффузии со средним значением 856 × 10–6 мм2/с (стрелки). Б — T1‐томограмма (нативная фаза) — образование представляется гиперинтенсивным (стрелки); В — ДВ‐МРТ (b = 800 с/мм2) — ограничение диффузии молекул воды не выявлено; Г — ИКД-карта: измеряемый коэффициент диффузии со средним значением 489 × 10–6. Choi H, Varma DGK, Fornage BD, et al Soft tissue sarcoma: MR imaging vs sonography for the detection of local recurrence after surgery. Blokhin National Medical Research Center of Oncology; 24 Kashirskoe Highway, Moscow, Russia 115478
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