Gradient-echo perfusion imaging of musculoskeletal abnormalities with contrast-enhanced two-dimensional...

The objective of this study was to evaluate the utility of MR perfusion imaging of various musculoskeletal lesions with a contrast-enhanced two-dimensional fat saturation fast low angle shot (FLASH) sequence and to assess the potential of this technique for distinguishing malignant from benign conditions. Thirty-six musculoskeletal lesions were studied at 1.5 T. The signal intensity of the lesions, adjacent artery, muscle, bone marrow, and fat were plotted against time. The time to peak enhancement, time to maximum signal intensity, percent enhancement, rate of peak enhancement, and rate of enhancement parameters were calculated. Because of a significant overlap between malignant and benign conditions, accuracy rates were lower than reported previously. The best parameter based on these values was the rate of peak enhancement (sensitivity, 84.6%; specificity, 65.2-66.6%; positive predictive value, 57.8-68.7%). Fat saturation gradient-echo MR perfusion imaging allows for a rapid assessment of the vascularity of musculoskeletal pathology; however, a significant overlap persists between malignant neoplasms and several benign conditions.