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Value of ultrasonographic evaluation for soft-tissue lesions: focus on incidentally detected lesions on CT/MRI

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Abstract

Soft-tissue lesions of the musculoskeletal system are commonly encountered in clinical practice and often manifest as palpable lesions. Moreover, the increasing use of cross-sectional imaging such as CT or MRI has resulted in the incidental detection of many soft-tissue lesions. Ultrasonography remains the primary imaging investigation for soft-tissue lesions. It has been shown to be helpful in depicting processes involving the soft-tissue lesions on cross-sectional imaging. This article describes the ultrasonographic findings of the most frequently incidentally detected benign and malignant soft-tissue lesions on cross-sectional imaging and suggests the characteristics of such diseases, focusing on the ultrasonographic features that allow accurate diagnosis. Familiarity with the clinical setting and the appearance of soft-tissue lesions on both ultrasonography and cross-sectional imaging can lead to accurate diagnosis and appropriate management of the condition.

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References

  1. Carra BJ, Bui-Mansfield LT, O’Brien SD, Chen DC. Sonography of musculoskeletal soft-tissue masses: techniques, pearls, and pitfalls. AJR Am J Roentgenol. 2014;202(6):1281–90.

    Article  PubMed  Google Scholar 

  2. DiDomenico P, Middleton W. Sonographic evaluation of palpable superficial masses. Radiol Clin North Am. 2014;52(6):1295–305.

    Article  PubMed  Google Scholar 

  3. Pierucci A, Teixeira P, Zimmermann V, et al. Tumours and pseudotumours of the soft tissue in adults: perspectives and current role of sonography. Diagn Interv Imaging. 2013;94(3):238–54.

    Article  CAS  PubMed  Google Scholar 

  4. Widmann G, Riedl A, Schoepf D, Glodny B, Peer S, Gruber H. State-of-the-art HR-US imaging findings of the most frequent musculoskeletal soft-tissue tumors. Skeletal Radiol. 2009;38(7):637–49.

    Article  PubMed  Google Scholar 

  5. Hwang S, Adler RS. Sonographic evaluation of the musculoskeletal soft tissue masses. Ultrasound Q. 2005;21(4):259–70.

    Article  PubMed  Google Scholar 

  6. Kransdorf MJ, Murphey MD. Radiologic evaluation of soft-tissue masses: a current perspective. AJR Am J Roentgenol. 2000;175(3):575–87.

    Article  CAS  PubMed  Google Scholar 

  7. van Rijswijk CS, Geirnaerdt MJ, Hogendoorn PC, et al. Soft-tissue tumors: value of static and dynamic gadopentetate dimeglumine-enhanced MR imaging in prediction of malignancy. Radiology. 2004;233(2):493–502.

    Article  PubMed  Google Scholar 

  8. Lin J, Jacobson JA, Fessell DP, Weadock WJ, Hayes CW. An illustrated tutorial of musculoskeletal sonography: part 4, musculoskeletal masses, sonographically guided interventions, and miscellaneous topics. AJR Am J Roentgenol. 2000;175(6):1711–9.

    Article  CAS  PubMed  Google Scholar 

  9. Lee MH, Kim NR, Ryu JA. Cyst-like solid tumors of the musculoskeletal system: an analysis of ultrasound findings. Skeletal Radiol. 2010;39(10):981–6.

    Article  PubMed  Google Scholar 

  10. Machado P, Segal S, Lyshchik A, Forsberg F. A novel microvascular flow technique: initial results in thyroids. Ultrasound Q. 2016;32(1):67–74.

    Article  PubMed  Google Scholar 

  11. Lee DH, Lee JY, Han JK. Superb microvascular imaging technology for ultrasound examinations: initial experiences for hepatic tumors. Eur J Radiol. 2016;85(11):2090–5.

    Article  PubMed  Google Scholar 

  12. Zhan J, Diao XH, Jin JM, Chen L, Chen Y. Superb microvascular imaging—a new vascular detecting ultrasonographic technique for avascular breast masses: a preliminary study. Eur J Radiol. 2016;85(5):915–21.

    Article  PubMed  Google Scholar 

  13. Koyama N, Hata J, Sato T, Tomiyama Y, Hino K. Assessment of hepatic fibrosis with superb microvascular imaging in hepatitis C virus-associated chronic liver diseases. Hepatol Res. 2017;47(6):593–7.

    Article  PubMed  Google Scholar 

  14. Piscaglia F, Bolondi L, Italian Society for Ultrasound in M, Biology Study Group on Ultrasound Contrast A. The safety of Sonovue in abdominal applications: retrospective analysis of 23188 investigations. Ultrasound Med Biol. 2006;32(9):1369–75.

    Article  PubMed  Google Scholar 

  15. Nolsoe CP, Lorentzen T. International guidelines for contrast-enhanced ultrasonography: ultrasound imaging in the new millennium. Ultrasonography. 2016;35(2):89–103.

    Article  PubMed  Google Scholar 

  16. Kim SJ, Park HJ, Lee SY. Usefulness of strain elastography of the musculoskeletal system. Ultrasonography. 2016;35(2):104–9.

    Article  PubMed  Google Scholar 

  17. Drakonaki EE, Allen GM, Wilson DJ. Ultrasound elastography for musculoskeletal applications. Br J Radiol. 1019;2012(85):1435–45.

    Google Scholar 

  18. Chung HW, Cho KH. Ultrasonography of soft tissue “oops lesions”. Ultrasonography. 2015;34(3):217–25.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Loizides A, Peer S, Plaikner M, Djurdjevic T, Gruber H. Perfusion pattern of musculoskeletal masses using contrast-enhanced ultrasound: a helpful tool for characterisation? Eur Radiol. 2012;22(8):1803–11.

    Article  PubMed  Google Scholar 

  20. Inampudi P, Jacobson JA, Fessell DP, et al. Soft-tissue lipomas: accuracy of sonography in diagnosis with pathologic correlation. Radiology. 2004;233(3):763–7.

    Article  PubMed  Google Scholar 

  21. Wagner JM, Lee KS, Rosas H, Kliewer MA. Accuracy of sonographic diagnosis of superficial masses. J Ultrasound Med. 2013;32(8):1443–50.

    Article  PubMed  Google Scholar 

  22. Murphey MD, Carroll JF, Flemming DJ, Pope TL, Gannon FH, Kransdorf MJ. From the archives of the AFIP: benign musculoskeletal lipomatous lesions. Radiographics. 2004;24(5):1433–66.

    Article  PubMed  Google Scholar 

  23. Lalitha P, Reddy M, Reddy KJ. Musculoskeletal applications of elastography: a pictorial essay of our initial experience. Korean J Radiol. 2011;12(3):365–75.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Lee JC, Thomas JM, Phillips S, Fisher C, Moskovic E. Aggressive fibromatosis: MRI features with pathologic correlation. AJR Am J Roentgenol. 2006;186(1):247–54.

    Article  PubMed  Google Scholar 

  25. Vandevenne JE, De Schepper AM, De Beuckeleer L, et al. New concepts in understanding evolution of desmoid tumors: MR imaging of 30 lesions. Eur Radiol. 1997;7(7):1013–9.

    Article  CAS  PubMed  Google Scholar 

  26. Teo HE, Peh WC, Shek TW. Case 84: desmoid tumor of the abdominal wall. Radiology. 2005;236(1):81–4.

    Article  PubMed  Google Scholar 

  27. Nozaki T, Matsusako M, Mimura H, et al. Imaging of vascular tumors with an emphasis on ISSVA classification. Jpn J Radiol. 2013;31(12):775–85.

    Article  CAS  PubMed  Google Scholar 

  28. Olsen KI, Stacy GS, Montag A. Soft-tissue cavernous hemangioma. Radiographics. 2004;24(3):849–54.

    Article  PubMed  Google Scholar 

  29. Blacksin MF, Ha DH, Hameed M, Aisner S. Superficial soft-tissue masses of the extremities. Radiographics. 2006;26(5):1289–304.

    Article  PubMed  Google Scholar 

  30. Kollipara R, Odhav A, Rentas KE, Rivard DC, Lowe LH, Dinneen L. Vascular anomalies in pediatric patients: updated classification, imaging, and therapy. Radiol Clin North Am. 2013;51(4):659–72.

    Article  PubMed  Google Scholar 

  31. Kim HY, Kang CH, Kim JH, Lee SH, Park SY, Cho SW. Intramuscular and subcutaneous sparganosis: sonographic findings. J Clin Ultrasound. 2008;36(9):570–2.

    Article  PubMed  Google Scholar 

  32. Cho JH, Lee KB, Yong TS, et al. Subcutaneous and musculoskeletal sparganosis: imaging characteristics and pathologic correlation. Skeletal Radiol. 2000;29(7):402–8.

    Article  CAS  PubMed  Google Scholar 

  33. Huang CC, Ko SF, Huang HY, et al. Epidermal cysts in the superficial soft tissue: sonographic features with an emphasis on the pseudotestis pattern. J Ultrasound Med. 2011;30(1):11–7.

    Article  CAS  PubMed  Google Scholar 

  34. Lee HS, Joo KB, Song HT, et al. Relationship between sonographic and pathologic findings in epidermal inclusion cysts. J Clin Ultrasound. 2001;29(7):374–83.

    Article  CAS  PubMed  Google Scholar 

  35. Park HJ, Lee SY, Lee SM, Kim WT, Lee S, Ahn KS. Strain elastography features of epidermoid tumours in superficial soft tissue: differences from other benign soft-tissue tumours and malignant tumours. Br J Radiol. 1050;2015(88):20140797.

    Google Scholar 

  36. Loyer EM, DuBrow RA, David CL, Coan JD, Eftekhari F. Imaging of superficial soft-tissue infections: sonographic findings in cases of cellulitis and abscess. AJR Am J Roentgenol. 1996;166(1):149–52.

    Article  CAS  PubMed  Google Scholar 

  37. Chung WJ, Chung HW, Shin MJ, et al. MRI to differentiate benign from malignant soft-tissue tumours of the extremities: a simplified systematic imaging approach using depth, size and heterogeneity of signal intensity. Br J Radiol. 1018;2012(85):e831–6.

    Google Scholar 

  38. De Schepper AM, Ramon FA, Degryse HR. Statistical analysis of MRI parameters predicting malignancy in 141 soft tissue masses. Rofo. 1992;156(6):587–91.

    Article  PubMed  Google Scholar 

  39. Galant J, Marti-Bonmati L, Soler R, et al. Grading of subcutaneous soft tissue tumors by means of their relationship with the superficial fascia on MR imaging. Skeletal Radiol. 1998;27(12):657–63.

    Article  CAS  PubMed  Google Scholar 

  40. Bodner G, Schocke MF, Rachbauer F, et al. Differentiation of malignant and benign musculoskeletal tumors: combined color and power Doppler US and spectral wave analysis. Radiology. 2002;223(2):410–6.

    Article  PubMed  Google Scholar 

  41. Murphey MD. World Health Organization classification of bone and soft tissue tumors: modifications and implications for radiologists. Semin Musculoskelet Radiol. 2007;11(3):201–14.

    Article  PubMed  Google Scholar 

  42. Son E, Park J, Jeon H, Cho S. Malignant fibrous histiocytoma (MFH) in axilla. Yonsei Med J. 2004;45(4):736–8.

    Article  PubMed  Google Scholar 

  43. Beaman FD, Kransdorf MJ, Andrews TR, Murphey MD, Arcara LK, Keeling JH. Superficial soft-tissue masses: analysis, diagnosis, and differential considerations. Radiographics. 2007;27(2):509–23.

    Article  PubMed  Google Scholar 

  44. Pretorius ES, Fishman EK. Helical CT of skeletal muscle metastases from primary carcinomas. AJR Am J Roentgenol. 2000;174(2):401–4.

    Article  CAS  PubMed  Google Scholar 

  45. Rubens DJ, Fultz PJ, Gottlieb RH, Rubin SJ. Effective ultrasonographically guided intervention for diagnosis of musculoskeletal lesions. J Ultrasound Med. 1997;16(12):831–42.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, 06973, Korea

    Sung Bin Park

  2. Department of Radiology, Ulsan University Hospital, Ulsan University College of Medicine, Ulsan, Korea

    Byeong Seong Kang

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  1. Sung Bin Park
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  2. Byeong Seong Kang
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Correspondence to Sung Bin Park.

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Park, S.B., Kang, B.S. Value of ultrasonographic evaluation for soft-tissue lesions: focus on incidentally detected lesions on CT/MRI. Jpn J Radiol 35, 485–494 (2017). https://doi.org/10.1007/s11604-017-0657-4

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  • DOI: https://doi.org/10.1007/s11604-017-0657-4

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