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Tumour and tumour-like conditions of the soft tissue: magnetic resonance imaging features differentiating benign from malignant masses

George Hermann, MD Ibrahim Fikry Abdelwahab, MD Theodore T. Miller, MD Michael J. Klein, MD ^* and Michael M. Lewis, MD

Department of Radiology, Orthopedics of The Mount Sinai Medical Center, CUNY, New York, USA ^* Department of Pathology, Orthopedics of The Mount Sinai Medical Center, CUNY, New York, USA Department of Orthopedics of The Mount Sinai Medical Center, CUNY, New York, USA

49 primary soft-tissue masses were studied by magnetic resonance imaging (MRI) in an effort to differentiate benign from malignant lesions. There were 24 benign and 25 malignant tumours. Images were evaluated for the presence of low-signal septation, changes in pattern of homogeneity, signal intensity, and margin definition and shape. 20 of the 25 malignant tumours (80%) demonstrated low-signal septation, and two of the 24 benign tumours (8%) also demonstrated this feature. Malignant tumours tended to change pattern from being homogeneous on T₁-weighted images to being heterogeneous on T₂-weighted images (72%). Benign tumours maintained their pattern on both sequences (67%). Only three of the 24 benign tumours (12.5%) changed from being homogeneous to heterogeneous. Our findings suggest that tumours which change pattern, from homogeneous on T₁-weighted images to heterogeneous on T₂-weighted images, and tumours which have low-signal septations are likely to be malignant. Moreover benign lesions tend to have well defined margins, and some benign masses have characteristic appearances that aid in their differentiation from malignant processes.

Key Words: Soft-tissue tumour • MRI • Benign • Malignant

Received for publication March 5, 1991. Revision received June 21, 1991. Accepted for publication July 23, 1991.

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