Hemangiomas of skeletal muscle: MR findings in five patients

Skeletal muscle hemangiomas are uncommon tumors of young adults. More than 90% are misdiagnosed preoperatively. Plain-film examinations, bone scans, CT studies, and angiography may not always be specific for this tumor. Seven MR examinations were performed in five young adult patients with pathologically proved skeletal muscle hemangiomas. All five hemangiomas showed high signal intensity on both T1- and T2-weighted images. The signal intensity in these tumors was less than that of subcutaneous fat on relatively T1-weighted images and greater than that of fat on relatively T2-weighted images. Four tumors had a serpiginous pattern. Four patients had focal muscle atrophy. Three patients had all three findings (high signal intensity on both T1- and T2-weighted images, serpiginous pattern, and associated focal muscle atrophy) while the other two patients had at least two of the three findings. These three patients did not undergo angiography or needle biopsies before surgery because the MR findings were highly suggestive of hemangioma. Our experience with this small series of patients suggests that skeletal muscle hemangiomas have a consistent appearance on MR. MR may be able to contribute significantly to the preoperative diagnosis of this tumor and may also supply valuable information about the extent of the lesion.