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Semin Musculoskelet Radiol 2000; 4(4): 435-458
DOI: 10.1055/s-2000-13170
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Imaging of Muscle Tumors

Paul Weatherall
  • Associate Professor of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
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Publication History

Publication Date:
31 December 2000 (online)

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ABSTRACT

Tumors that involve skeletal muscle are numerous and varied, including a variety of benign and malignant neoplasms as well as other mass lesions. Confronted with a patient presenting with a mass in the muscle, a clinician has multiple choices for the initial study. Magnetic resonance imaging (MRI) frequently provides all of the information necessary to manage patients and so is a reasonable ``first-line'' imaging test. Although the MRI features of the various muscle masses are variable, general rules regarding characteristic features can provide restricted differential diagnosis. This article reviews these tumors and their appearances on MRI.

KEYWORD

Magnetic resonance imaging - neoplasm - abscess - muscles

REFERENCES

  • 1 Reiser M, Rupp N, Heller H J. MR-tomography in the diagnosis of malignant soft-tumors.  Eur J Radiol . 1984;  4 288-293
    PubMedGoogle Scholar
  • 2 Weekes R G, McLeod R A, Reiman H M, Pritchard D J. CT of soft-tissue neoplasms.  Am J Roentgenol . 1985;  144 355-360
    PubMedGoogle Scholar
  • 3 Petasnick J P, Turner D A, Charters J R, Gitelis S, Zacharias C E. Soft-tissue masses of the locomotor system: comparison of MRI with CT.  Radiology . 1986;  160 125-133
    PubMedGoogle Scholar
  • 4 Chang A E, Matory Y L, Dwyer A J. Magnetic resonance imaging versus computed tomography in the evaluation of soft tissue tumors of the extremities.  Ann Surg . 1987;  205 340-348
    PubMedGoogle Scholar
  • 5 Sundaram M, Duffrin H, McGuire M H. Synchronous multicentric desmoid tumors (aggressive fibromatosis) of the extremities.  Skeletal Radiol . 1988;  17 16-19
    CrossrefPubMedGoogle Scholar
  • 6 Demas B E, Heelan R T, Lane J. Soft-tissue sarcomas of the extremities: comparison of MRI and CT in determining the extent of disease.  Am JRoentgenol . 1988;  150 615-620
    PubMedGoogle Scholar
  • 7 Jordan J E, Donaldson S S, Enzmann D R. Cost effectiveness and outcome assessment of magnetic resonance imaging in diagnosing cord compression.  Cancer . 1995;  75(10) 2579-2586
    PubMedGoogle Scholar
  • 8 Hricak H, Powell C B, Yu K K. Invasive cervical carcinoma: role of MR imaging in pretreatment work-up-cost minimization and diagnostic efficacy analysis.  Radiology . 1996;  198(2) 403-409
    PubMedGoogle Scholar
  • 9 Trieshmann Jr W H, Mosure J C. The impact of magnetic resonance imaging of the knee on surgical decision making.  Arthroscopy . 1996;  12(5) 550-555
    PubMedGoogle Scholar
  • 10 Weinstabl R, Muellner T, Vecsei V, Kainberger F, Kramer M. Economic considerations for the diagnosis and therapy of meniscal lesions: can magnetic resonance imaging help reduce the expense?.  World J Surg . 1997;  21(4) 363-368
    PubMedGoogle Scholar
  • 11 Rubin S J, Marquardt J D, Gottlieb R H. Magnetic resonance imaging: a cost-effective alternative to bone scintigraphy in the evaluation of patients with suspected hip fractures.  Skeletal Radiol . 1998;  27(4) 199-204
    CrossrefPubMedGoogle Scholar
  • 12 Berquist T H, Ehman R L, King B F. Value of MR imaging in differentiating benign from malignant soft-tissue masses: study of 95 lesions.  Am J Roentgenol . 1990;  155 1251-1255
    PubMedGoogle Scholar
  • 13 Moulton J S, Blebea J S, Dunco D M. MR imaging of soft-tissue masses: diagnostic efficacy and value of distinguishing between benign and malignant lesions.  Am J Roentgenol . 1995;  164(5) 1191-1199
    PubMedGoogle Scholar
  • 14 Lundorf E, Keller J O, Nielsen O S, Jensen O M, Christensen T. Can magnetic resonance imaging differentiate between benign and malignant conditions in patients with skeletal or soft tissue tumors?.  Ugeskr Laeger . 1996;  158(11) 1518-1520
    PubMedGoogle Scholar
  • 15 Soler R, Castro J M, Rodriguez E. Value of MR findings in predicting the nature of the soft tissue lesions: benign, malignant or undetermined lesion?.  Comput Med Imaging Graph . 1996;  20(3) 163-169
    PubMedGoogle Scholar
  • 16 Van Der Woude J H, Verstraete K L, Hogendoorn P C. Musculoskeletal tumors: does fast dynamic contrast-enhanced subtraction MR imaging contribute to the characterization.  Radiology . 1998;  208(3) 821-828
    PubMedGoogle Scholar
  • 17 Vanel D, Shapeero L G, DeBaere T. MR imaging in the follow-up of malignant and aggressive soft-tissue tumors: results of 511 examinations.  Radiology. 1994;  Jan;190(1) 263-268
    PubMedGoogle Scholar
  • 18 Hermann G, Abdelwahab I F, Miller T T. Tumor and tumor-like conditions of the soft tissue: magnetic resonance imaging features differentiating benign from malignant masses.  Br J Radiol . 1992;  65 14-20
    PubMedGoogle Scholar
  • 19 Jelinek J S, Kransdorf M J, Shmookler B M. Liposarcoma of the extremities: MR and CT findings in the histologic subtypes.  Radiology . 1993;  186 454-459
    PubMedGoogle Scholar
  • 20 Wetzel L H, Levine E. Soft-tissue tumors of the foot: value of MRI for specific diagnosis.  Am J Roentgenol . 1990;  155 1025-1030
    PubMedGoogle Scholar
  • 21 Binkovitz L A, Berquist T H, McLeod R A. Masses of the hand and wrist: detection and characterization with MR imaging.  Am J Roentgenol . 1990;  154 323-326
    PubMedGoogle Scholar
  • 22 Jelinek J S, Kransdorf M J, Shmookler B M, Aboulafia A A, Malawer M M. Giant cell tumor of the tendon sheath: MR finding in nine cases.  Am J Roentgenol . 1994;  162(4) 919-922
    PubMedGoogle Scholar
  • 23 Cohen E K, Kressel H Y, Frank T S. Hyaline cartilage-origin bone and soft tissue neoplasms: MR appearance and histologic correlation.  Radiology . 1988;  167 477-481
    PubMedGoogle Scholar
  • 24 Kransdorf M J, Jelinek J S, Moser R P. Magnetic resonance appearance of fibromatosis: a report of 14 cases and review of the literature.  Skeletal Radiol . 1990;  19 495-499
    PubMedGoogle Scholar
  • 25 Suh J S, Hwang G, Hahn S B. Soft tissue hemangiomas: MR manifestations in 23 patients.  Skeletal Radiol . 1994;  23(8) 621-625
    PubMedGoogle Scholar
  • 26 Ma L D, Frassica F J, McCarthy E F, Bluemke D A, Zerhouni E A. Benign and malignant musculoskeletal masses: MR imaging differentiation with rim-to-center differential enhancement ratios.  Radiology . 1997;  202 739-744
    PubMedGoogle Scholar
  • 27 Llauger J, Palmer J, Monill J M. MR imaging of benign soft-tissue masses of the foot and ankle.  Radiographics . 1998;  18(6) 1481-1498
    CrossrefPubMedGoogle Scholar
  • 28 Capelastegui A, Astigarraga E, Fernandez-Canton G. Masses and pseudomasses of the hand and wrist: MR findings in 134 cases.  Skeletal Radiol . 1999;  28(9) 498-507
    CrossrefPubMedGoogle Scholar
  • 29 Yiu-Chiu V S, Chiu L C. Complementary values of ultra- sound and computed tomography in the evaluation of musculoskeletal masses.  Radiographics . 1983;  3 46-82
    PubMedGoogle Scholar
  • 30 Hermann G, Yeh H C, Schwartz I. Computed tomography of soft-tissue lesions of the extremities, pelvic and shoulder girdles: monographic and pathological correlations.  Clin Radiol . 1984;  35 193-202
    CrossrefPubMedGoogle Scholar
  • 31 Bernardino M E, Jing B-S, Thomas J L, Lindell Jr M M, Zornoza J. The extremity soft-tissue lesion: a comparative study of ultrasound, computed tomography, and xeroradiography.  Radiology . 1981;  139 53-59
    PubMedGoogle Scholar
  • 32 Itoh K. A comparative study between magnetic resonance imaging and histological findings of bone and soft tissue tumors.  Nippon Seikeigeka Gakkai Zasshi . 1995;  69(10) 899-914
    PubMedGoogle Scholar
  • 33 Panicek D M, Gatsonis C, Rosenthal D I. CT and MR imaging in the local staging of primary malignant musculoskeletal neoplasms: report of the radiology diagnostic oncology group.  Radiology . 1997;  202(1) 237-246
    CrossrefPubMedGoogle Scholar
  • 34 Chew F S, Hudson T M, Enneking W F. Radionuclide imaging of soft tissue neoplasms.  Semin Nucl Med . 1981;  11 266-276
    PubMedGoogle Scholar
  • 35 McAfee J G, Samin A. In-111 labeled leukocytes- a review of problems in image interpretation.  Radiology . 1985;  155 222-229
    PubMedGoogle Scholar
  • 36 Kairemo K JA, Wiklund T A, Liewendahl K. Imaging of soft-tissue sarcomas with indium-111-labeled monoclonal antimyosin fab fragments.  J Nucl Med . 1990;  31 23-31
    PubMedGoogle Scholar
  • 37 Weatherall P T, Maale G E. Neoplasms and mass lesions involving muscle. Muscle Imaging in Health and Disease 1996, Chap. 31, pp 385-412
    Google Scholar
  • 38 Enneking W F, Maale G E. The effect of the tumoral contamination of wounds.  Cancer . 1988;  62 1251-1256
    CrossrefPubMedGoogle Scholar
  • 39 Weatherall P T. Benign and malignant masses MR imaging differentiation.  MRI Clinics of North America. 1995;  3(4) 793-799/Appendix
    PubMedGoogle Scholar
  • 40 Kransdorf M J, Murphey M D. The use of gadolinium in the MR evaluation of soft tissue tumors.  Seminars Ultrasound CT MRI . 1997;  18(4) 251-268
    PubMedGoogle Scholar
  • 41 Mirowitz S A, Totty W G, Lee J KT. Characterization of musculoskeletal masses using dynamic Gd-DTPA enhanced spin-echo MRI.  J Comput Assist Tomogr . 1992;  16 120-125
    PubMedGoogle Scholar
  • 42 Fletcher B D, Fhanna S L. Musculoskeletal neoplasms: dynamic Gd-DTPT-enhanced MRI [letter].  Radiology . 1989;  171 287
    PubMedGoogle Scholar
  • 43 Hanna S L, Fletcher B D, Parham D M. Muscle edema in musculoskeletal tumors: MR imaging characteristics and clinical significance.  J Magn Reson Imaging . 1991;  1 441-449
    PubMedGoogle Scholar
  • 44 Herrlin K, Ling L B, Pettersson H. Gadolinium-DTPA enhancement of soft tissue tumors in magnetic resonance imaging.  Acta Radiol . 1990;  31 233
    PubMedGoogle Scholar
  • 45 Kransdorf M J. Soft-tissue masses: a systematic approach to radiologic evaluation. RSNA Categorical Course in Diagnostic Radiology: Body MR 1999: 189-200
    Google Scholar
  • 46 Beltran J, Simon D C, Katz W. Increased MR signal intensity in skeletal muscle adjacent to malignant tumors: pathologic correlation and clinical relevance.  Radiology . 1987;  162 251-255
    PubMedGoogle Scholar
  • 47 Kransdorf M J, Jelinek J, Moser R. Soft-tissue masses: Diagnosis using MR imaging.  Am J Roentgenol . 1989;  153 541-547
    PubMedGoogle Scholar
  • 48 Jones B C, Sundaram M, Kransdorf M J. Synovial sarcoma: MR imaging findings in 34 patients.  Am J Roentgenol . 1993;  161(4) 827-830
    PubMedGoogle Scholar
  • 49 DeSchepper A, Ramon F, Degryse H. Statistical analysis of MRI parameters predicting malignancy in 141 soft tissue masses.  ROFO . 1992;  156 587-591
    PubMedGoogle Scholar
  • 50 Sundaram M, Baran G, Merenda G. Myxoid liposarcoma: magnetic resonance imaging appearances with clinical and histological correlation.  Skeletal Radiol . 1990;  19 359-362
    PubMedGoogle Scholar
  • 51 Mahajan H, Kim E E, Wallace S. Magnetic resonance imaging of malignant fibrous histiocytoma.  Magn Res Imag . 1989;  7 283-288
    CrossrefPubMedGoogle Scholar
  • 52 Crim J R, Seeger L L, Yao L. Diagnosis of soft-tissue masses with MR imaging: can benign masses be differentiated from malignant ones?.  Radiology . 1992;  185 581-586
    CrossrefPubMedGoogle Scholar
  • 53 Morton M J, Berquist T H, McLeod R A. MR imaging of synovial sarcoma.  AJR . 1991;  156 337-340
    PubMedGoogle Scholar
  • 54 London J, Kim E E, Wallace S. MR imaging of liposarcomas: correlation of MR features and histology.  J Comp Assist Tomogr . 1989;  13 832-835
    PubMedGoogle Scholar
  • 55 Ma L D, Frassica F J, Scott Jr W W, Fishman E K, Zerbouni E A. Differentiation of benign and malignant musculoskeletal tumors: potential pitfalls with MR imaging.  Radiographics . 1995;  15(2) 349-366
    CrossrefPubMedGoogle Scholar
  • 56 Weatherall P T, Maale G E, Sherry C S. High T1-weighted signal intensity in MR imaging of soft tissue sarcomas.  J Magn Reson Imaging . 1991;  1(abstract) 194
    PubMedGoogle Scholar
  • 57 Lee V S, Martinez S, Coleman R E. Primary muscle lymphoma: clinical and imaging findings.  Radiology . 1997;  203(1) 237-244
    PubMedGoogle Scholar
  • 58 Weatherall P T. Benign and malignant masses MR imaging differentiation.  MRI Clinics of North America . 1995;  3(4) 674-677
    PubMedGoogle Scholar
  • 59 Kransdorf M J. Malignant soft-tissue tumors in a large referral population: distribution of specific diagnoses by age, sex, and location.  Am J Roentgenol . 1995;  164 129-134
    PubMedGoogle Scholar
  • 60 Panicek D M, Casper E S, Brennan M F, Hajdu S I, Heelan R T. Hemorrhage simulating tumor growth in malignant fibrous histiocytoma at MRI.  Radiology . 1991;  181 398-400
    PubMedGoogle Scholar
  • 61 Soulie D, Boyer B, Lescop J, Pujol A, Le Friant G, Cordoliani Y S. [Myxoid liposarcoma.  MRI imaging]. J Radiol . 1995;  76(1) 29-36
    PubMedGoogle Scholar
  • 62 Enzinger F M, Weiss S W. Rhabdomyoma. In: Soft Tissue Tumors, 2nd ed. St Louis: C.V. Mosby 1988: 363-366
    Google Scholar
  • 63 Madewell J E, Sweet D E. Tumors and tumor-like lesions in or about joints. In: Resnick D, Niwayama G., eds. Diagnosis of Bone and Joint Disorders, 2nd ed Philadelphia: W.B. Saunders 1988: 3891-3900
    Google Scholar
  • 64 Enzinger F M, Weiss S W. Rhabdomyosarcoma. In: Soft Tissue Tumors, 2nd ed. St Louis: C.V. Mosby 1988: 448-488
    Google Scholar
  • 65 Biondetti P R, Ehman R L. Soft-tissue sarcomas: use of textural patterns in skeletal muscle as a diagnostic feature in postoperative MR imaging.  Radiology . 1992;  183(3) 845-848
    Google Scholar
  • 66 Miller T T, Potter H G, McCormack Jr R R. Benign soft tissue masses of the wrist and hand: MRI appearances.  Skeletal Radiol . 1994;  23(5) 327-332
    CrossrefPubMedGoogle Scholar
  • 67 Kransdorf M J. 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
    PubMedGoogle Scholar
  • 68 Enzinger F M, Weiss S W. Rhabdomyoma. In: Soft Tissue Tumors, 2nd ed. St Louis: C.V. Mosby 1988: 433-447
    Google Scholar
  • 69 Arkun R, Memis A, Akalin T, Ustun E E, Sabah D, Kandiloglu G. Liposarcoma of soft tissue: MRI findings with pathologic correlation.  Skeletal Radiol . 1997;  26(3) 167-172
    CrossrefPubMedGoogle Scholar
  • 70 Enzinger F M, Weiss S W. Rhabdomyoma. In: Soft Tissue Tumors, 2nd ed. St Louis: C.V. Mosby 1988: 349-372
    Google Scholar
  • 71 Weatherall P T. Benign and malignant masses MR imaging differentiation.  MRI Clin North Am . 1995;  3(4) 669
    PubMedGoogle Scholar
  • 72 Bush C H, Spanier S S, Gillespy III T. Imaging of atypical lipomas of the extremities: report of three cases.  Skeletal Radiol . 1988;  17 472-475
    CrossrefPubMedGoogle Scholar
  • 73 Enzinger F M, Weiss S W. Benign lipomatous tumors. In: Soft Tissue Tumors, 2nd ed. St. Louis: C.V. Mosby; 1988;304-317, 351, 363-366
    Google Scholar
  • 74 Soderlund V, Goranson H, Bauer H C. MR imaging of benign peripheral nerve sheath tumors.  Acta Radiol . 1994;  35(3) 282-286
    PubMedGoogle Scholar
  • 75 Weatherall P T, Erdman W A, Rollins N A. The STIR technique in musculoskeletal MRI.  SMRM Book of Abstracts . 1988;  1 1878
    PubMedGoogle Scholar
  • 76 Burk Jr L D, Brunberg J A, Kanal E, Latchaw R E, Wolf G L. Spinal and paraspinal neurofibromatosis surface coil MRI at 1.5 T1.  Radiology . 1987;  162 797-801
    PubMedGoogle Scholar
  • 77 Greenspan A, McGahan J P, Vogelsang P. Imaging strategies in the evaluation of soft-tissue hemangiomas of the extremities: correlation of the findings of plain radiography, angiography, CT, MRI, and ultrasonography in 12 histologically proven cases.  Skeletal Radiol . 1992;  21 11-18
    PubMedGoogle Scholar
  • 78 Levine F, Wetzel L H, Neff J F. MR imaging and CT of extrahepatic cavernous hemangiomas.  Am J Roentgenol . 1986;  147 1299-1304
    PubMedGoogle Scholar
  • 79 Kaplan P A, Williams S M. Mucocutaneous and peripheral soft-tissue hemangiomas: MRI.  Radiology . 1987;  163 163-166
    PubMedGoogle Scholar
  • 80 Jenner G, Soderlund V, Bauer H F, Brosijo O. MR imaging of skeletal muscle hemangiomas. A report of 16 cases.  Acta Radiol . 1996;  37(2) 140-144
    PubMedGoogle Scholar
  • 81 Suh J-S, Abenoza P, Galloway H R. Peripheral (extracranial) nerve tumors: correlation of MR imaging and histologic findings.  Radiology . 1992;  183 341-346
    PubMedGoogle Scholar
  • 82 Cohen J M, Weinreb J C, Redman H C. Arteriovenous malformations of the extremities: MR imaging.  Radiology . 1986;  158 475-479
    PubMedGoogle Scholar
  • 83 Hawnaur J M, Jenkins J PR, Isherwood I. Magnetic resonance imaging of musculoaponeurotic fibromatosis.  Skeletal Radiol . 1990;  19 509-514
    PubMedGoogle Scholar
  • 84 Quinn S F, Erickson S J, Dee P M. MR imaging in fibromatosis: results in 26 patients with pathologic correlation.  AJR . 1991;  156 539-542
    PubMedGoogle Scholar
  • 85 Maale G E, Schwarz D, Weatherall P T. Results of treatment for extra-abdominal aggressive fibromatosis utilizing megavoltage radiation for local control. Proceedings of the 7th International Symposium on Limb Salvage, Singapore, August 1993
    Google Scholar
  • 86 Hudson T M, Vandergriend R A, Springfield D S. Aggressive fibromatosis: evaluation by computed tomography and angiography.  Radiology . 1984;  150 495-501
    PubMedGoogle Scholar
  • 87 Meyer C A, Kransdorf M J, Jelinek J S, Moser Jr P R. MR and CT appearance of nodular fasciitis.  J Comput Asst Tomogr . 1991;  15(2) 276-279
    PubMedGoogle Scholar
  • 88 Gordon B A, Martinez S, Collins A J. Pyomyositis: characteristics at CT and MR imaging.  Radiology . 1991;  197(1) 279-286
    PubMedGoogle Scholar
  • 89 Simon M A, Biermann J S. Biopsy of bone and soft-tissue lesions.  J Bone Joint Surgery . 1993;  75A(4) 616-621
    PubMedGoogle Scholar
  • 90 Marcantonio D R, Weatherall P T, Berrey Jr H B. Practical considerations in the imaging of soft tissue tumors.  Orthop Clin North Am . 1998;  29(1) 1-17
    CrossrefPubMedGoogle Scholar
  • 91 Fleckenstein J L, Weatherall P T, Bertocci L A. Locomotor system assessment by muscle magnetic resonance imaging.  Magn Reson Q . 1991;  7 79-103
    PubMedGoogle Scholar
  • 92 Schweitzer M E, Greenway G, Resnick D, Haghighi P, Snoots W E. Osteoma of soft parts.  Skeletal Radiol . 1992;  21 177-180
    PubMedGoogle Scholar
  • 93 Shirkhoda A, Armin A R, Bis K G. MR imaging of myositis ossificans: variable patterns at different stages.  J Magn Reson Imaging . 1995;  5(3) 287-292
    CrossrefPubMedGoogle Scholar
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