The Russell H. Morgan Department of Radiology & Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
J Magn Reson Imaging. 2019 Jul;50(1):11-27. doi: 10.1002/jmri.26659. Epub 2019 Feb 21.
The majority of peripheral musculoskeletal soft tissue masses encountered in routine clinical practice are benign and associated with an excellent prognosis, whereas a small proportion of soft tissue masses are malignant and are associated with higher morbidity and mortality. Owing to the excellent tissue contrast resolution provided, magnetic resonance imaging (MRI) is a primary modality for the diagnostic evaluation of soft tissue masses, particularly for defining the anatomic extent. MRI is also useful for the characterization of soft tissue masses; however, after the exclusion of cysts and lipomas, it is challenging to accurately categorize neoplastic lesions as benign or malignant with conventional anatomic MRI. Quantitative MRI biomarkers obtained with nonconventional pulse sequences are becoming increasingly available, and can improve the accuracy of determining the character of soft tissue masses. In this article we discuss established qualitative and emerging quantitative MRI-based biomarkers available with dynamic contrast-enhanced MRI, diffusion-weighted imaging, and MR spectroscopy and their utility for the characterization of untreated soft tissue masses. Level of Evidence: 5 Technical Efficacy Stage: 5 J. Magn. Reson. Imaging 2019;50:11-27.
在常规临床实践中遇到的大多数周围肌肉骨骼软组织肿块是良性的,预后良好,而一小部分软组织肿块是恶性的,发病率和死亡率较高。由于磁共振成像(MRI)提供了极好的组织对比分辨率,因此它是软组织肿块诊断评估的主要方式,特别是用于确定解剖范围。MRI 也可用于软组织肿块的特征描述;然而,在排除囊肿和脂肪瘤后,用常规解剖 MRI 准确地将肿瘤性病变归类为良性或恶性具有挑战性。使用非传统脉冲序列获得的定量 MRI 生物标志物越来越多,并且可以提高确定软组织肿块特征的准确性。本文讨论了现有的定性和新兴的定量 MRI 生物标志物,这些生物标志物可用于动态对比增强 MRI、弥散加权成像和磁共振波谱,以及它们在未治疗的软组织肿块特征描述中的应用。证据水平:5 技术效果阶段:5 J. 磁共振成像 2019;50:11-27.