The role of magnetic resonance imaging in the evaluation of Ewing sarcoma

Abstract

The experience with magnetic resonance imaging (MRI) in 27 patients with Ewing sarcoma is reported and compared with computed tomography (CT) and plain films. Plain radiography proved to be the best imaging method to asses probable histological diagnosis in all cases (n = 6). For the evaluation of chemotherapeutic response (n = 4), CT and MRI gave the same information about the variation in size of the tumor. In this small series, the high signal in T2 weighted images was not altered significantly by therapy. In preoperative evaluation (n = 14), MRI gave better information than CT of soft tissue involvement and extension within the bone marrow in two cases each. The ability of MRI to accurately define extension through the epiphyseal plate in two cases permitted limb salvage which otherwise would not have been possible. In the long-term follow-up (n = 12), three patients without recurrence one year after therapy showed a low signal in the surgical area in T2 weighted images. Nine patients had a high signal in T2 weighted images: four were reactive lesions, two had obvious recurrence, and one was a hematoma. In the two remaining cases plain films and CT were normal, in the presence of both active tumor and reactive lesions. It was not possible with MRI to differentiate active tumor from reactive change, even after Gd-DTPA infusion.

Mri Evaluation of Musculoskeletal Tumours

“…There was one case of malignant giant cell tumour of humerus, which showed cortical permeation and an associated soft tissue mass as shown by Murphey et al 7 One case of Ewing's sarcoma was present in our study, which was confirmed on histopathology in which MRI gave better information on soft tissue involvement and extension within the bone marrow similar to study done by Frouge C et al 8 Two cases of sacrococcygeal chordoma were present in our study, which showed adjacent soft tissue involvement and bilateral sacroiliac joints involvement was seen in one case.…”

Lesions of juxtacortical origin (surface lesions of bone)

“…33). MRI is the best diagnostic modality in evaluating the medulla of bone and the extent of the medullary involvement [145]. Biopsy then confirmed the diagnosis of Ewing's sarcoma.…”

Ewing's Sarcoma Family of Tumors: Current Management

“…The most precise definition of the local extent of disease, including the intramedullary portion and the relation of the lesion to adjacent blood vessels and nerves, is provided by magnetic resonance imaging (MRI) (Fig. 2) [3,[7][8][9][10].…”