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.
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Aisen AM, Martel W, Braunstein EM, McMillin Kl, Phillips WA, Kling TF (1986) MRI and CT evaluation of primary bone and soft tissue tumors. AJR 146:749
Bloem JL, Bluemm RG, Taminiau AHM, Van Oosterom AT, Stolk J, Doornbos J (1987) MRI of primary malignant bone tumors. Radiographics 7:425
Bohndorf K, Reiser M, Lochner B, Féaux de Lacroix W, Steinbrich W (1986) Magnetic resonance imaging of primary tumours and tumour-like lesions of bone. Skeletal Radiol 15:511
Brady TJ, Rosen BR, Pykett IL, McGuire MH, Mankin HJ, Rosenthal DI (1983) NMR imaging of leg tumors. Radiology 149:181
Coffre C, Vanel D, Contesso G, Kalifa C, Dubousset J, Genin J, Masselot J (1985) Problems and pitfalls in the use of computed tomography for the local evaluation of long bone osteosarcoma: Report on 30 cases. Skeletal Radiol 13:147
Cohen MD, Klatte EC, Baehner R, Smith JA, Martin-Simmerman P, Carr BE, Provisor AJ, Weetman RM, Coates T, Siddiqui A, Weismann SJ, Berkow R, McKenna S (1984) Magnetic resonance imaging of bone marrow disease in children. Radiology 151:715
Hudson TM, Hamlin DJ, Enneking WF, Pettersson H (1985) Magnetic resonance imaging of bone and soft tissue tumors: Early experience in 31 patients compared with computed tomography. Skeletal Radiol 13:134
Hudson TM, Schakel M, Springfield DS (1985) Limitation of CT following excisional biopsy of soft tissue sarcomas. Skeletal Radiol 13:49
Hudson TM, Schiebler M, Springfield DS, Hawkins IF, Enneking WF, Spanier SS (1983) Radiologic imaging of osteosarcoma: Role in planning surgical treatment. Skeletal Radiol 10:137
Laval-Jeantet M, Buy JN, Roger B, Delepine G (1984) MRI in the preoperative evaluation of primary osseous malignant tumors. Book of abstracts: Society of Magnetic Resonance in Medicine 1984, Berkeley, California. Society of Magnetic Resonance in Medicine, p 455
Pettersson H, Gillespy T, Hamlin D, Enneking WF, Springfield DS, Andrew ER, Spanier S, Slone R (1987) Primary musculoskeletal tumors: Examination with MR imaging compared with conventional modalities. Radiology 164: 237
Pettersson H, Hamlin DJ, Mancuso A, Scott KN (1985) Magnetic resonance of the musculoskeletal system. Acta Radiol [Diagn] (Stockh) 26:225
Reinus WR, Gilula LA (1984) IESS Committee. Radiology of Ewing's sarcoma: Intergroup Ewing's sarcoma study (IESS). Radiographics 4:929
Reiser M, Rupp N, Biehl TH, Allgayer B, Heller Hl, Lukas P, Fink U (1985) MR in the diagnosis of bone tumours. Eur J Radiol 5:1
Richardson ML, Kilcoyne RF, Gillespy T, Helms CA, Genant HK (1986) Magnetic resonance imaging of musculoskeletal neoplasms. Radiol Clin North Am 24:259
Smith J, Heelan RT, Huvos AG, Caparros B, Rosen G, Urmacher C, Caravelli JF (1982) Radiographic changes in primary osteogenic sarcoma following intensive chemotherapy. Radiology 143:355
Vanel D, Contesso G, Couanet D, Piekarski JD, Sarrazin D, Masselot J (1982) Computed tomography in evaluation of 41 cases of Ewing's sarcoma. Skeletal Radiol 9:8
Vanel D, Di Paola R, Contesso G (1987) MRI in musculoskeletal primary malignant tumors. In: Kressel H (ed) Magnetic resonance annual. Raven, New York, p 237
Vanel D, Lacombe MJ, Couanet D, Kalifa C, Spielmann M, Genin J (1987) Musculoskeletal tumors: Follow-up with MR imaging after treatment with surgery and radiation therapy. Radiology 164:243
Zimmer WD, Berquist TH, McLeod RA, Sim FH, Pritchard DJ, Shives TC, Wold LE, May GR (1985) Bone tumors: Magnetic resonance imaging versus computed tomography. Radiology 155:709
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Frouge, C., Vanel, D., Coffre, C. et al. The role of magnetic resonance imaging in the evaluation of Ewing sarcoma. Skeletal Radiol 17, 387–392 (1988). https://doi.org/10.1007/BF00361656
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DOI: https://doi.org/10.1007/BF00361656