[The presurgical staging of soft-tissue sarcomas of the extremities: imaging diagnosis].
The authors studied 43 patients affected with soft tissue sarcomas to evaluate the accuracy of different imaging modalities in predicting resectability. Locations included lower (30) and upper (11) limbs, axillary (2) and gluteal (2) regions. MR imaging was performed on 37 patients, CT on 35 and US on 30. All patients were preliminarily subjected to conventional radiographic examination. MR imaging proved to be the most reliable modality because it allowed the lesion site to be correctly determined relative to both anatomical compartments and lesion spread; its relationships to joints and vascular structures were also depicted. Intravenous administration of Gd-DTPA (to 9 patients) allowed important information to be gained as to identifying and quantifying tumoral necrosis, and made it possible to discriminate tumoral component from perilesional edema. In our experience, CT was shown to overstage the T parameter--due to difficult distinction of edemigen component, even with a careful use of angio-CT. On the contrary, CT was the modality of choice in recognizing bone cortical infiltrations, even small ones, and in identifying pulmonary metastases. US played a role in the staging of these neoplasms thanks to its recognizing even small lesions and, in case of suspected vascular involvement, it allowed even small infiltrations of the vascular wall to be demonstrated.
Crecco
M
M
Istituto di Radiologia, II Università di Roma Tor Vergata.
Squillaci
E
E
Cossu
E
E
Vidiri
A
A
Di Filippo
F
F
Cavaliere
R
R
Simonetti
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D001132:Arm; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D019786:Gadolinium DTPA; D006801:Humans; D007866:Leg; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009942:Organometallic Compounds; D004369:Pentetic Acid; D012509:Sarcoma / Q000175:diagnosis* / Q000473:pathology; D012983:Soft Tissue Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D005682:Gadolinium; D019786:Gadolinium DTPA
Stadiazione prechirurgica dei sarcomi dei tessuti molli delle estremità: diagnostica per immagini.