Evaluation of vascular invasion in patients with musculoskeletal tumors of lower extremities: use of time-resolved 3D MR angiography at 3-T

Abstract

Background Time-resolved angiography with stochastic trajectories (TWIST) sequence makes considerable progress in temporal and spatial resolution, which presents high potential in evaluation of vascular diseases. Purpose To assess magnetic resonance imaging (MRI) using TWIST MR angiography (MRA) sequence in the assessment of vascular invasion for bone and soft-tissue tumors in comparison to computed tomography angiography (CTA) as the reference standard. Material and Methods Thirty-three patients with lower extremity musculoskeletal tumors were imaged with conventional MR and TWIST MRA. CTA was performed 48 h later. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the femoral artery were calculated. Vascular invasion as determined by MRA and CTA was separately analyzed. Vascular invasion by MRA and CTA were analyzed with kappa coefficients to determine agreement between the imaging methods. Results Seven cases of bone and 26 cases of soft tissue tumors were examined. SNR and CNR of the femoral artery were excellent for TWIST MRA (mean ± SD values of 317 ± 80 and 276 ± 76, respectively). Based on the TWIST sequence, the vessels were free of tumor in 16 cases. Vascular displacement was found in 11 cases and vascular stenosis in six cases. The MRA findings conflicted with CTA findings in only one case. The kappa value was 0.953 ( P < 0.01). In five cases, vascular malformations were found with TWIST MRA but not CTA. Conclusion TWIST MRA enables accurate delineation of anatomical structures and tumor arterial involvement, providing reliable preoperative imaging information with respect to lower extremity musculoskeletal tumors.

Comparison Between Time-Resolved Magnetic Resonance Angiography and Diagnostic Digital Subtraction Angiography in the Vascular Assessment of Nonspecific Aorto-Arteritis Patients: A Prospective Study

“…Jin et al assessed the role of TWIST MR angiography to evaluate the vascular invasion in musculoskeletal tumors of lower extremities and found out that it reliably delineates the vascular involvement. 9 Armstrong et al evaluated the role of TWIST MRA in helping to image the complex central venous accesses and concluded that it can reliably identify the candidate sites for the venous catheter insertion. 10 Korn et al found double bolus injection TWIST-MRA helps the evaluation of cervical arteries with the elimination of venous contamination.…”

The development of musculoskeletal radiology for 100 years as presented in the pages of Acta Radiologica

“…In the 1970s, there was an interest in angiography in extremity trauma (49,50) and in 1982, a comparison with CT was published (51). With improved angiographic techniques, there was a renewed interest in tumor imaging at the end of the 20th century (52) and angiography migrated from conventional catheter techniques towards CT (53,54) and MR (55) angiography in tumor evaluation.…”

Readout-segmented diffusion tensor imaging for assessing sciatic nerve invasion by soft tissue tumor

“…Soft tissue mass of leg usually invades adjacent vessels and nerves. 1,2 Computed tomography angiography (CTA) is the rst-line test in revealing arterial invasion by tumor. 2 Magnetic resonance angiography (MRA) serves as an alternative to CTA.…”

“…1,2 Computed tomography angiography (CTA) is the rst-line test in revealing arterial invasion by tumor. 2 Magnetic resonance angiography (MRA) serves as an alternative to CTA. 2 However, CTA and MRA have di culty in identifying nerve invasion by tumor.…”

“…2 Magnetic resonance angiography (MRA) serves as an alternative to CTA. 2 However, CTA and MRA have di culty in identifying nerve invasion by tumor. 3 In recent years, fast spin echo (FSE) T2 weighted imaging (T2WI) was found useful in depicting peripheral nerve.…”