PURPOSE: To evaluate the diagnostic capability of contrast-enhanced multidetector computed tomography (MDCT) for the preoperative assessment of musculoskeletal masses, in comparison with magnetic resonance imaging and plain radiographs (MRI+X-p). MATERIALS AND METHODS: Sixty-eight patients with musculoskeletal masses underwent plain radiography, MRI, and contrast-enhanced MDCT. The following five items were evaluated for all images: histological properties, vascularity, neurovascular involvement, calcification/ossification, and cortical/marrow involvement. The MDCT images with three-dimensional reconstruction were retrospectively compared with MRI+X-p. RESULTS: In 32 bone lesions, MDCT was superior/equal/inferior to MRI+X-p regarding histological properties in 4/10/18, vascularity in 0/11/21, neurovascular involvement in 0/26/6, calcification/ossification in 15/17/0, and cortical/marrow involvement in 29/3/0 cases, respectively. In 36 soft-tissue lesions, MDCT was superior/equal/inferior to MRI+X-p with histological properties in 1/18/17, vascularity in 0/12/24, neurovascular involvement in 1/24/11, calcification/ossification in 8/28/0, and cortical/marrow involvement in 7/29/0 cases, respectively. The MDCT evaluation of both calcification/ossification and cortical/marrow involvement in bone lesions was superior to that in soft-tissue lesions (p<0.05). There were no statistically significant differences between benign and malignant lesions in the evaluation of each of the five items. CONCLUSION: MDCT provided additional and more comprehensive information than MRI+X-p for the preoperative assessment of musculoskeletal masses, especially for calcification/ossification and cortical/marrow involvement. Three-dimensional contrast-enhanced MDCT images can be adopted equally to MRI for the preoperative evaluation of neurovascular involvement.
PURPOSE: To evaluate the diagnostic capability of contrast-enhanced multidetector computed tomography (MDCT) for the preoperative assessment of musculoskeletal masses, in comparison with magnetic resonance imaging and plain radiographs (MRI+X-p). MATERIALS AND METHODS: Sixty-eight patients with musculoskeletal masses underwent plain radiography, MRI, and contrast-enhanced MDCT. The following five items were evaluated for all images: histological properties, vascularity, neurovascular involvement, calcification/ossification, and cortical/marrow involvement. The MDCT images with three-dimensional reconstruction were retrospectively compared with MRI+X-p. RESULTS: In 32 bone lesions, MDCT was superior/equal/inferior to MRI+X-p regarding histological properties in 4/10/18, vascularity in 0/11/21, neurovascular involvement in 0/26/6, calcification/ossification in 15/17/0, and cortical/marrow involvement in 29/3/0 cases, respectively. In 36 soft-tissue lesions, MDCT was superior/equal/inferior to MRI+X-p with histological properties in 1/18/17, vascularity in 0/12/24, neurovascular involvement in 1/24/11, calcification/ossification in 8/28/0, and cortical/marrow involvement in 7/29/0 cases, respectively. The MDCT evaluation of both calcification/ossification and cortical/marrow involvement in bone lesions was superior to that in soft-tissue lesions (p<0.05). There were no statistically significant differences between benign and malignant lesions in the evaluation of each of the five items. CONCLUSION: MDCT provided additional and more comprehensive information than MRI+X-p for the preoperative assessment of musculoskeletal masses, especially for calcification/ossification and cortical/marrow involvement. Three-dimensional contrast-enhanced MDCT images can be adopted equally to MRI for the preoperative evaluation of neurovascular involvement.
Authors: Ty K Subhawong; Elliot K Fishman; Jennifer E Swart; John A Carrino; Samer Attar; Laura M Fayad Journal: AJR Am J Roentgenol Date: 2010-06 Impact factor: 3.959