Magnetic resonance imaging of musculoskeletal tumors

In summary, MRI is the preferred modality for the evaluation of a soft-tissue mass following radiography. The radiologic appearance of certain soft-tissue tumors or tumor-like processes such as benign fatty tumors, intramuscular hemangiomas, pigmented villonodular synovitis, and certain hematomas may be sufficiently unique to allow a strong presumptive radiologic diagnosis. It must be emphasized that MRI cannot reliably distinguish between benign and malignant lesions and, when radiologic evaluation is nonspecific, one is ill advised to suggest a lesion is benign or malignant solely on its MR appearance. The role of MRI in the evaluation of bone tumors is predominantly one of staging. MRI is superb to evaluate the extent of intraosseous and soft-tissue involvement as well as the relationship of the lesion to the neurovascular bundle. Unfortunately, MRI remains nonspecific and is unable to predict lesion histology. Finally, the value of Gd-DTPA enhanced imaging is still to be determined.