Three-dimensional images of contrast-enhanced MDCT for preoperative assessment of musculoskeletal masses: comparison with MRI and plain radiographs.
OBJECTIVE
To evaluate the diagnostic capability of contrast-enhanced multidetector computed tomography (MDCT) for the preoperative assessment of musculoskeletal masses, in comparison with magnetic resonance imaging and plain radiographs (MRI+X-p).


METHODS
Sixty-eight patients with musculoskeletal masses underwent plain radiography, MRI, and contrast-enhanced MDCT. The following five items were evaluated for all images: histological properties, vascularity, neurovascular involvement, calcification/ossification, and cortical/marrow involvement. The MDCT images with three-dimensional reconstruction were retrospectively compared with MRI+X-p.


RESULTS
In 32 bone lesions, MDCT was superior/equal/inferior to MRI+X-p regarding histological properties in 4/10/18, vascularity in 0/11/21, neurovascular involvement in 0/26/6, calcification/ossification in 15/17/0, and cortical/marrow involvement in 29/3/0 cases, respectively. In 36 soft-tissue lesions, MDCT was superior/equal/inferior to MRI+X-p with histological properties in 1/18/17, vascularity in 0/12/24, neurovascular involvement in 1/24/11, calcification/ossification in 8/28/0, and cortical/marrow involvement in 7/29/0 cases, respectively. The MDCT evaluation of both calcification/ossification and cortical/marrow involvement in bone lesions was superior to that in soft-tissue lesions (p<0.05). There were no statistically significant differences between benign and malignant lesions in the evaluation of each of the five items.


CONCLUSIONS
MDCT provided additional and more comprehensive information than MRI+X-p for the preoperative assessment of musculoskeletal masses, especially for calcification/ossification and cortical/marrow involvement. Three-dimensional contrast-enhanced MDCT images can be adopted equally to MRI for the preoperative evaluation of neurovascular involvement.
Mori
Takeki
T
Department of Radiology, Kobe Red Cross Hospital, 1-3-1 Wakihama Kaigan-dori, Chuo-ku, Kobe 651-0073, Japan.
Fujii
Masahiko
M
Akisue
Toshihiro
T
Yamamoto
Tetsuji
T
Kurosaka
Masahiro
M
Sugimura
Kazuro
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D002648:Child; D003287:Contrast Media; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D011856:Radiographic Image Enhancement / Q000379:methods*; D011859:Radiography / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D003287:Contrast Media