J Korean Soc Magn Reson Med.  2014 Dec;18(4):279-289. 10.13104/jksmrm.2014.18.4.279.

Soft Tissue Masses Showing Low Signal Intensity on T2-weighted Images: Correlation with Pathologic Findings

• Song YS
• Lee IS
• Choi KU
• Cho KH
• Lee SM
• Lee YH
• Kim JI

• KMID: 2206925
• DOI: http://doi.org/10.13104/jksmrm.2014.18.4.279

Abstract

OBJECTIVE
The aims of this article are to differentiate soft tissue masses showing low signal intensity on T2-weighted images (T2WIs) according to the histopathologic findings.
CONCLUSION
To know relatively small numbered soft tissue masses with low signal intensities on T2WIs adding characteristic location, morphology, signal intensities on other sequences might be helpful for differential diagnosis of mostly nonspecific soft tissue tumors on MRI.

Keyword

Soft tissue neoplasm; MR imaging; T2WI; hypointense

MeSH Terms

Diagnosis, Differential
Magnetic Resonance Imaging
Soft Tissue Neoplasms

Figure

• 

  Fig. 1 61-year-old male patient with a fibroma of the tendon sheath. (a) On a coronal fat suppressed T2-weighted image, the mass located at the lateral aspect of the vastus lateralis muscle shows signal intensity equal to that of skeletal muscle. This finding is attributable to the high quantity of collagen in many of these tumors. (b) A photomicrograph (H & E staining, ×200) shows hypocellularity and the mass contains a dense collagenous matrix and scattered spindle-shaped fibroblasts.

• 

  Fig. 2 19-year-old male patient with nodular fasciitis. (a) On a sagittal fat-suppressed T2WI of the forearm, a well-defined soft tissue mass shows signal intensity higher than that of the subcutaneous fat and muscle. (b) A photomicrograph (H & E staining, ×400) shows increased cellularity. There are few foci of myxoid degeneration.

• 

  Fig. 3 40-year-old male patient with fibromatosis. (a) A mass located at the anterior chest wall shows signal intensity slightly higher than that of skeletal muscle on a T2WI. The mass contains a region with lower signal intensity. (b) A photomicrograph (H & E staining, ×100) shows a lesion that is predominantly fibrotic with low cellularity and with heavy collagen deposition.

• 

  Fig. 4 80-year-old male patient with a malignant fibrous histiocytoma. (a) On an axial T2WI of the right thigh, the mass located at the superficial aspect of the fascia shows intermediate signal intensity higher than that of skeletal muscle. (b) A photomicrograph (H & E staining, ×40) shows hypercellularity with a relatively low collagen content.

• 

  Fig. 5 64-year-old male patient with an elastofibroma. (a) An axial T2WI shows soft tissue with signal intensity similar to that of the adjacent skeletal muscle, interlaced with streaks of tissue with signal intensity of fat between the inferior margin of the scapula and posterior chest wall. This appearance corresponds to areas of dense fibrous connective tissue interlaced with areas of fat. (b) A photomicrograph (H & E staining, ×400) demonstrates scattered elastic fibers in a background of collagenous tissue. Relative hypocellularity is seen.

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  Fig. 6 45-year-old male patient with a fibrolipoma. (a) An axial T2WI shows the nonadipose component to have decreased signal intensity similar to that of muscle. Note the presence of adipose tissue in the interstices of the mass. (b) A photomicrograph (H & E staining, ×100) shows fibrolipomatous proliferation around the nerves (arrowheads). The presence of fibrous septae (arrow) is noted.

• 

  Fig. 7 31-year-old male patient with an amputation neuroma. (a) The mass (arrows) located at the ventral aspect of the distal portion of the amputated forearm shows a fascicular sign on an axial T2WI of the forearm. (b) A photomicrograph (H & E staining, ×100) shows numerous nerve bundles and the surrounding fibroblasts with a collagenous matrix.

• 

  Fig. 8 34-year-old female patient with two neurofibromas. (a) An axial T2WI shows a well-defined mass with a center of low signal intensity and high signal intensity peripheral rim (target sign) through two muscular compartments. (b) A photomicrograph (H & E staining, ×200) shows scattered neurofibroma cells and a background of loosely packed collagen fibers and myxoid stroma.

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  Fig. 9 33-year-old female patient with diffuse-type giant cell tumor(pigmented villonodular synovitis). (a) A fat-suppressed axial T2WI (a) shows a lobulated mass with low signal intensity in the retrocalcaneal bursa. (b) Photomicrographs (H & E staining, ×100) demonstrate the presence of multiple foci of hemosiderin deposits.

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  Fig. 10 60-year-old female patient with synovial osteochondromatosis. (a) On a sagittal T2WI of the ankle, multiple areas of signal void are noted within the effusion of the posterior ankle joint. (b) A corresponding plain radiograph shows the presence of multiple calcified nodules.

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  Fig. 11 40-year-old female patient with myositis ossificans. (a) A sagittal T2WI shows an inhomogeneous, well-defined mass surrounded by diffuse edema in the anteromedial aspect of the upper arm. The mass is surrounded by a thin hypointense rim, representing peripheral ossification. (b) As seen on a plain radiograph, a faintly mineralized mass is present.

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  Fig. 12 11-year-old male patient with a pilomatricoma. (a) On a coronal T2WI, a heterogeneous low signal intensity mass is seen in the subcutaneous fat layer of the cheek. (b) A photomicrograph (H & E staining, ×40) shows calcifications and ossification.

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  Fig. 13 25-year-old male patient with intravascular papillary endothelial hyperplasia. (a) A coronal T2WI of the thigh shows a well-defined mass with a hyperintense peripheral region and multiple hypointense or isointense central regions. (b) A photomicrograph (H & E staining, ×100) shows hemorrhage and a thrombus (arrows).

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  Fig. 14 26-year-old male patient with an alveolar soft part sarcoma. A coronal T2WI of the thigh shows a lobulated margined mass with higher signal intensity than that of the skeletal muscle and lower signal intensity than that of fat. Note the serpentine flow voids, representing enlarged blood vessels. Signal voids (arrows) are seen at the margin of the tumor.

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  Fig. 15 15-year-old male patient with an epidermoid cyst. (a) A coronal T2WI obtained through the abdominal wall shows a well-defined mass of intermediate to high signal intensity with dot-like low signal components in the subcutaneous fat layer. (b) A photomicrograph (H & E staining, ×100) shows keratin debris within the epithelial lining.

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