Neurotized Free Muscle Flaps can Produce MRI Changes Mimicking Tumour Recurrence.
Soft tissue sarcomas are investigated by magnetic resonance imaging (MRI) both for initial staging and follow-up. We describe the presence of increased signal on T2-weighted images caused by a neurotized muscle flap following reconstructive surgery. This raised concern about possible sarcoma recurrence that was not clinically evident. On post-operative imaging of sarcomas the presence of recurrent tumour is indicated by a mass and high signal intensity on T2-weighted images. However, high signal changes in skeletal muscle on T2-weighted images are not specific. In this case, the free functioning muscle transfer with neurotization of the flap mimicked recurrence on MR scan. High signal intensity on T2-weighted images in muscle is an indication of either a physiological change or a pathological condition and must be taken in context of the clinical picture.
Departments of Radiology and Plastic and Reconstructive Surgery Royal Devon and Exeter Hospital Barrack Road Exeter EX2 5DW UK.
J K
JK
O'Neill
J A
JA
Barrett
T
T
Cobley
V
V
Devaraj
D A T
DA
Silver