Panicek D M, Schwartz L H, Heelan R T, Caravelli J F
Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Skeletal Radiol. 1995 Apr;24(3):185-90. doi: 10.1007/BF00228920.
The objective of this study was to describe a variety of non-neoplastic causes of high-signal-intensity areas seen on T2-weighted magnetic resonance (MR) images obtained after treatment for malignant musculoskeletal neoplasm.
MR examinations obtained after treatment for malignant musculoskeletal neoplasm in 11 patients were reviewed. The examinations of these patients were selected because at least one MR study of each patient showed high-signal-intensity areas on T2-weighted images at or near the site of the original tumor. The MR imaging findings were correlated with results of biopsy in four patients, and with information from follow-up radiologic examinations and the patients' medical records in all cases, to determine the cause of the high-signal-intensity areas.
Non-neoplastic entities responsible for high-signal-intensity areas included postsurgical seroma, hematoma, postradiation therapy changes, fat necrosis and seroma, surgical hemostatic packing material, intercalary bone allograft, strut bone graft, atrophic muscle, and herniated colon and bladder. Knowledge of details of the surgical procedure and the time interval since surgery or irradiation aided in accurate interpretation of the findings, but did not allow immediate biopsy to be deferred in every case.
High-signal-intensity areas on T2-weighted images in patients previously treated for malignant musculoskeletal neoplasm may represent a variety of entities other than residual or recurrent neoplasm, even in the presence of a mass. The MR imaging findings should be interpreted in conjunction with details of the specific clinical circumstances to prevent misdiagnosis and unnecessary biopsy.
本研究的目的是描述在恶性肌肉骨骼肿瘤治疗后获得的T2加权磁共振（MR）图像上所见高信号强度区域的多种非肿瘤性病因。
回顾了11例接受恶性肌肉骨骼肿瘤治疗后进行的MR检查。选择这些患者的检查是因为每位患者至少有一项MR研究显示在原肿瘤部位或其附近的T2加权图像上有高信号强度区域。将MR成像结果与4例患者的活检结果以及所有病例的后续放射学检查信息和患者病历相关联，以确定高信号强度区域的病因。
导致高信号强度区域的非肿瘤性病变包括术后血清肿、血肿、放射治疗后改变、脂肪坏死和血清肿、手术止血填充材料、间置骨移植、支撑骨移植、萎缩性肌肉以及结肠和膀胱疝出。了解手术过程细节以及自手术或放疗后的时间间隔有助于对结果进行准确解读，但并非在每种情况下都能避免立即进行活检。
既往接受过恶性肌肉骨骼肿瘤治疗的患者，其T2加权图像上的高信号强度区域可能代表除残留或复发性肿瘤之外的多种病变，即使存在肿块。MR成像结果应结合具体临床情况的细节进行解读，以防止误诊和不必要的活检。
