MR imaging in fibromatosis: results in 26 patients with pathologic correlation.

Fibromatoses are a diverse group of soft-tissue lesions that have been inconsistently categorized and treated. The purpose of our study was to establish the range of appearances of fibromatoses on MR images and perform a pathologic correlation to explain the variable signal-intensity patterns. During a 3-year period, 26 patients with deep fibromatoses were examined with MR. The MR images were evaluated for signal-intensity characteristics, and findings were correlated retrospectively with the pathologic diagnoses. The results showed that the MR appearance of fibromatoses is similar to that of other soft-tissue lesions, and the signal intensities vary greatly from lesion to lesion and within lesions themselves. The fibromatoses were either hyperintense, isointense, hypointense, or of mixed signal intensity relative to adjacent skeletal muscle. The hypointense areas appear to be zones of hypocellularity and dense collagen deposition. Microscopically all of the lesions invaded adjacent structures, but the MR appearances of the margins varied and were judged to be well demarcated (n = 14), intermediate (n = 5), or poorly demarcated (n = 6). Our experience shows that fibromatoses have a variable MR appearance no different from that of other soft-tissue lesions, and this variability reflects the composition and cellularity of the lesions.

Post-traumatic osteolysis of the clavicle: MR features.

We present the magnetic resonance findings in a pathologically proven case of post-traumatic osteolysis of the distal clavicle. High signal intensity tissue centered on the acromioclavicular joint was seen on T2-weighted images, consistent with synovial proliferation.

Color Doppler sonographic imaging in the assessment of upper-extremity deep venous thrombosis.

Color Doppler flow imaging with linear-array transducers was performed in 130 extremities in 91 patients with suspected upper-extremity deep venous thrombosis. Thrombi were detected in 39 studies (30%). Eighty-four patients had either imaging examinations (22 studies comprising venography in 20 patients, CT in one, and MR imaging in one) or clinical follow-up (99 studies) for correlation. In studies with imaging correlation, the sensitivity of the Doppler studies was 78% and the specificity was 92%. There were two false-negative examinations in which the proximal subclavian vein either could not be imaged or the anatomy was distorted. There was one false-positive color Doppler diagnosis of deep venous thrombosis in a case of partial obstruction of the subclavian vein caused by extrinsic compression. There were no known additional errors in color Doppler imaging in patients who had clinical follow-up. Four cases of isolated superior vena cava or proximal innominate vein obstruction were missed by color Doppler imaging. Color Doppler flow imaging is an accurate, noninvasive method for the evaluation of upper-extremity deep venous thrombosis. Other imaging tests may be required when the color Doppler study is negative and central venous thrombosis is suspected.