Synovial sarcoma: dynamic contrast-enhanced MR imaging features

Abstract 

Objective. To determine whether previously described so-called malignant dynamic contrast-enhanced magnetic resonance (MR) imaging features – early start, peripheral enhancement and early plateau or washout phase – occur consistently in synovial sarcoma.

Design and patients. Dynamic contrast-enhanced MR images of 10 patients with histologically proven synovial sarcoma were reviewed. The start, pattern and progression of tumor enhancement were assessed and correlated with histopathology.

Results. In all patients, the time interval between arterial and early tumor enhancement was less than 7 s (mean 4.40 s, SD 2.09 s). Six synovial sarcomas showed enhancement with a subsequent rapidly progressive linear increase in signal intensity followed by a plateau in one lesion and washout in five. Four lesions showed a late sustained increase in enhancement after the initial rapid increase in enhancement. The pattern of initial enhancement was peripheral in only two lesions, diffuse in four and heterogeneous in four lesions.

Conclusions. Enhancement of tumor within 7 s after arterial enhancement is, of the three parameters described previously, the only sign that occurs consistently in synovial sarcoma.