Rofo 2019; 191(04): 323-332
DOI: 10.1055/a-0715-2205
Review
© Georg Thieme Verlag KG Stuttgart · New York

Radiologische Diagnostik von Weichteiltumoren im Erwachsenenalter: MRT-Bildgebung ausgewählter Entitäten mit Abgrenzung zwischen benignen und malignen Tumoren

Artikel in mehreren Sprachen: English | deutsch
Catharina Silvia Lisson
Department of Diagnostic and Interventional Radiology, University-Hospital of Ulm, Germany
,
Christoph Gerhard Lisson
Department of Diagnostic and Interventional Radiology, University-Hospital of Ulm, Germany
,
Meinrad Beer
Department of Diagnostic and Interventional Radiology, University-Hospital of Ulm, Germany
,
Stefan Andreas Schmidt
Department of Diagnostic and Interventional Radiology, University-Hospital of Ulm, Germany
› Institutsangaben
Weitere Informationen

Publikationsverlauf

19. Februar 2018

11. August 2018

Publikationsdatum:
18. Dezember 2018 (online)

Zusammenfassung

Ziel In der Differenzierung unklarer Weichteiltumoren stellt die MRT die wichtigste und sensitivste Bildgebungsmodalität dar. Dabei hilft eine systematische Herangehensweise, die große Zahl möglicher Differenzialdiagnosen einzuengen.

Methode Unsere Übersichtsarbeit stellt systematisch die MR-tomografischen Charakteristika der wichtigsten weichteiligen Raumforderungen gegenüber und will helfen, einen Zugang zu diesen oft schwierigen Tumorentitäten zu erhalten.

Ergebnisse und Schlussfolgerung Durch die MRT als wichtigster Baustein in der Bildgebung von Weichteiltumoren ist eine nähere Einordnung der Tumorentität und oft auch eine Differenzierung zwischen benignen und malignen Raumforderungen möglich.

Kernaussagen:

  • Die MRT ist die Methode der Wahl zur Abklärung eines unklaren Weichteiltumors.

  • Durch eine systematische Herangehensweise kann zwischen benignen und unklaren Läsionen differenziert werden.

  • Bei unklaren Läsionen sollte zum Malignitätsausschluss eine Biopsie erfolgen.

Zitierweise

  • Lisson CS, Lisson CG, Beer M et al. Radiological Diagnosis of Soft Tissue Tumors in Adults: MRI Imaging of Selected Entities Delineating Benign and Malignant Tumors. Fortschr Röntgenstr 2019; 191: 323 – 332

 
  • Literatur

  • 1 Breitenseher M. Bildgebende Diagnostik und Therapie der Weichteiltumoren: mit pathologischer Klassifikation, Nuklearmedizin, interventioneller Therapie; 21 Tabellen. Thieme; 2008
  • 2 Bannasch H, Eisenhardt SU, Grosu AL. et al. The diagnosis and treatment of soft tissue sarcomas of the limbs. Deutsches Arzteblatt international 2011; 108: 32-38
  • 3 Murphey MD, Carroll JF, Flemming DJ. et al. From the archives of the AFIP: benign musculoskeletal lipomatous lesions. Radiographics 2004; 24: 1433-1466
  • 4 Kransdorf MJ, Bancroft LW, Peterson JJ. et al. Imaging of fatty tumors: distinction of lipoma and well-differentiated liposarcoma. Radiology 2002; 224: 99-104
  • 5 Bancroft LW, Kransdorf MJ, Peterson JJ. et al. Benign fatty tumors: classification, clinical course, imaging appearance, and treatment. Skeletal radiology 2006; 35: 719-733
  • 6 Goldblum JR, Weiss SW, Folpe AL. Enzinger and Weiss's Soft Tissue Tumors E-Book. Elsevier Health Sciences; 2013
  • 7 Jelinek JS, Kransdorf MJ, Shmookler BM. et al. Liposarcoma of the extremities: MR and CT findings in the histologic subtypes. Radiology 1993; 186: 455-459
  • 8 Zhang H, Erickson-Johnson M, Wang X. et al. Molecular testing for lipomatous tumors: critical analysis and test recommendations based on the analysis of 405 extremity-based tumors. Am J Surg Pathol 2010; 34: 1304-1311
  • 9 Wang XL, De Schepper AM, Vanhoenacker F. et al. Nodular fasciitis: correlation of MRI findings and histopathology. Skeletal radiology 2002; 31: 155-161
  • 10 Fletcher CDM, Unni KK, Mertens F. et al. Pathology and Genetics of Tumours of Soft Tissue and Bone. IARC Press; 2002
  • 11 Crundwell N, O'Donnell P, Saifuddin A. Non-neoplastic conditions presenting as soft-tissue tumours. Clinical radiology 2007; 62: 18-27
  • 12 Parikh J, Hyare H, Saifuddin A. The imaging features of post-traumatic myositis ossificans, with emphasis on MRI. Clinical radiology 2002; 57: 1058-1066
  • 13 Kransdorf MJ, Meis JM. From the archives of the AFIP. Extraskeletal osseous and cartilaginous tumors of the extremities. Radiographics 1993; 13: 853-884
  • 14 Jackson DW. Managing Myositis Ossificans in the Young Athlete. Physician and Sportsmedicine 1975; 3: 56-61
  • 15 Berlien H, Poetke M, Philipp C. et al. Phakomatosen. In: Oldhafer M. Hrsg Transitionsmedizin. Stuttgart: Schattauer; 2015: 169-180
  • 16 International Society for the Study of Vascular Anomalies. ISSVA classification for vascular anomalies (Approved at the 20th ISSVA Workshop, Melbourne, April 2014, last revision May 2018). Available via http://www.issva.org/UserFiles/file/ISSVA-Classification-2018.pdf . Accessed 7 Jul 2018
  • 17 Berlien H, Urban P, Poetke M. et al. Klassifikation der Vaskulären Malformationen. Phlebologie 2016; 45: 295-303
  • 18 Kransdorf MJ, Murphey MD. Imaging of Soft Tissue Tumors. Lippincott Williams & Wilkins; 2006
  • 19 Vilanova JC, Barcelo J, Smirniotopoulos JG. et al. Hemangioma from head to toe: MR imaging with pathologic correlation. Radiographics 2004; 24: 367-385
  • 20 Murphey MD, Fairbairn KJ, Parman LM. et al. From the archives of the AFIP. Musculoskeletal angiomatous lesions: radiologic-pathologic correlation. Radiographics 1995; 15: 893-917
  • 21 Papp DF, Khanna AJ, McCarthy EF. et al. Magnetic resonance imaging of soft-tissue tumors: determinate and indeterminate lesions. The Journal of bone and joint surgery American volume 2007; 89 (Suppl. 03) 103-115
  • 22 Myers BW, Masi AT. Pigmented villonodular synovitis and tenosynovitis: a clinical epidemiologic study of 166 cases and literature review. Medicine (Baltimore) 1980; 59: 223-238
  • 23 Dorwart RH, Genant HK, Johnston WH. et al. Pigmented villonodular synovitis of synovial joints: clinical, pathologic, and radiologic features. Am J Roentgenol 1984; 143: 877-885
  • 24 Al-Nakshabandi NA, Ryan AG, Choudur H. et al. Pigmented villonodular synovitis. Clinical radiology 2004; 59: 414-420
  • 25 Cotten A, Flipo RM, Chastanet P. et al. Pigmented villonodular synovitis of the hip: review of radiographic features in 58 patients. Skeletal radiology 1995; 24: 1-6
  • 26 Llauger J, Palmer J, Roson N. et al. Pigmented villonodular synovitis and giant cell tumors of the tendon sheath: radiologic and pathologic features. Am J Roentgenol 1999; 172: 1087-1091
  • 27 Karasick D, Karasick S. Giant cell tumor of tendon sheath: spectrum of radiologic findings. Skeletal radiology 1992; 21: 219-224
  • 28 De Beuckeleer L, De Schepper A, De Belder F. et al. Magnetic resonance imaging of localized giant cell tumour of the tendon sheath (MRI of localized GCTTS). Eur Radiol 1997; 7: 198-201
  • 29 Murphey MD, Rhee JH, Lewis RB. et al. Pigmented villonodular synovitis: radiologic-pathologic correlation. Radiographics 2008; 28: 1493-1518
  • 30 Kransdorf MJ. Benign soft-tissue tumors in a large referral population: distribution of specific diagnoses by age, sex, and location. Am J Roentgenol 1995; 164: 395-402
  • 31 Banks KP. The target sign: extremity. Radiology 2005; 234: 899-900
  • 32 Murphey MD, Smith WS, Smith SE. et al. From the archives of the AFIP. Imaging of musculoskeletal neurogenic tumors: radiologic-pathologic correlation. Radiographics 1999; 19: 1253-1280
  • 33 Kalayanarooj S. Benign and malignant soft tissue mass: magnetic resonance imaging criteria for discrimination. J Med Assoc Thai 2008; 91: 74-81
  • 34 Enochs WS, Hyslop WB, Bennett HF. et al. Sources of the increased longitudinal relaxation rates observed in melanotic melanoma. An in vitro study of synthetic melanins. Invest Radiol 1989; 24: 794-804
  • 35 White LM, Schweitzer ME, Khalili K. et al. MR imaging of primary lymphoma of bone: variability of T2-weighted signal intensity. Am J Roentgenol 1998; 170: 1243-1247
  • 36 Sundaram M, McGuire MH, Schajowicz F. Soft-tissue masses: histologic basis for decreased signal (short T2) on T2-weighted MR images. Am J Roentgenol 1987; 148: 1247-1250
  • 37 Dinauer PA, Brixey CJ, Moncur JT. et al. Pathologic and MR imaging features of benign fibrous soft-tissue tumors in adults. Radiographics 2007; 27: 173-187
  • 38 Martinez S, Vogler 3rd JB, Harrelson JM. et al. Imaging of tumoral calcinosis: new observations. Radiology 1990; 174: 215-222
  • 39 Harish S, Lee JC, Ahmad M. et al. Soft tissue masses with “cyst-like” appearance on MR imaging: Distinction of benign and malignant lesions. Eur Radiol 2006; 16: 2652-2660
  • 40 Stiskal MA, Neuhold A, Szolar DH. et al. Rheumatoid arthritis of the craniocervical region by MR imaging: detection and characterization. Am J Roentgenol 1995; 165: 585-592
  • 41 Kransdorf MJ, Murphey MD. Radiologic evaluation of soft-tissue masses: a current perspective. Am J Roentgenol 2000; 175: 575-587
  • 42 Ma LD, McCarthy EF, Bluemke DA. et al. Differentiation of benign from malignant musculoskeletal lesions using MR imaging: pitfalls in MR evaluation of lesions with a cystic appearance. Am J Roentgenol 1998; 170: 1251-1258
  • 43 Frassica FJ, Khanna JA, McCarthy EF. The role of MR imaging in soft tissue tumor evaluation: perspective of the orthopedic oncologist and musculoskeletal pathologist. Magn Reson Imaging Clin N Am 2000; 8: 915-927
  • 44 Ma LD, Frassica FJ, Scott Jr WW. et al. Differentiation of benign and malignant musculoskeletal tumors: potential pitfalls with MR imaging. Radiographics 1995; 15: 349-366
  • 45 Sundaram M, Sharafuddin MJ. MR imaging of benign soft-tissue masses. Magn Reson Imaging Clin N Am 1995; 3: 609-627
  • 46 Jelinek J, Kransdorf MJ. MR imaging of soft-tissue masses. Mass-like lesions that simulate neoplasms. Magnetic Resonance Imaging Clinics of North America 1995; 3: 727-741
  • 47 Beggs I. Pictorial review: imaging of peripheral nerve tumours. Clinical radiology 1997; 52: 8-17
  • 48 Blacksin MF, Siegel JR, Benevenia J. et al. Synovial sarcoma: frequency of nonaggressive MR characteristics. J Comput Assist Tomogr 1997; 21: 785-789
  • 49 Tateishi U, Hasegawa T, Beppu Y. et al. Prognostic significance of MRI findings in patients with myxoid-round cell liposarcoma. Am J Roentgenol 2004; 182: 725-731
  • 50 Misra A, Mistry N, Grimer R. et al. The management of soft tissue sarcoma. J Plast Reconstr Aesthet Surg 2009; 62: 161-174
  • 51 Verstraete KL, De Deene Y, Roels H. et al. Benign and malignant musculoskeletal lesions: dynamic contrast-enhanced MR imaging--parametric "first-pass" images depict tissue vascularization and perfusion. Radiology 1994; 192: 835-843
  • 52 van der Woude HJ, Verstraete KL, Hogendoorn PC. et al. Musculoskeletal tumors: does fast dynamic contrast-enhanced subtraction MR imaging contribute to the characterization?. Radiology 1998; 208: 821-828
  • 53 Kettelhack C, Wickede M, Vogl T. et al. 31Phosphorus-magnetic resonance spectroscopy to assess histologic tumor response noninvasively after isolated limb perfusion for soft tissue tumors. Cancer 2002; 94: 1557-1564
  • 54 Einarsdottir H, Karlsson M, Wejde J. et al. Diffusion-weighted MRI of soft tissue tumours. Eur Radiol 2004; 14: 959-963
  • 55 Dudeck O, Zeile M, Pink D. et al. Diffusion-weighted magnetic resonance imaging allows monitoring of anticancer treatment effects in patients with soft-tissue sarcomas. J Magn Reson Imaging 2008; 27: 1109-1113
  • 56 Burrell RA, McGranahan N, Bartek J. et al. The causes and consequences of genetic heterogeneity in cancer evolution. Nature 2013; 501: 338-345
  • 57 Lisson CS, Lisson CG, Flosdorf K. et al. Diagnostic value of MRI-based 3D texture analysis for tissue characterisation and discrimination of low-grade chondrosarcoma from enchondroma: a pilot study. Eur Radiol 2018; 28: 468-477