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Assessment of Vascular Invasion by Musculoskeletal Tumors of the Limbs: Use of Contrast-enhanced MR Angiography¹

¹ From the Service de Radiologie B, Service de Chirurgie Orthopédique, Hôpital Cochin, 27 rue du Faubourg Saint Jacques, 75679 Paris Cedex 14, France. From the 2000 RSNA Annual Meeting. Received October 7, 2004; revision requested December 15; revision received February 22, 2005; accepted March 15; final version accepted April 15. Address correspondence to A.F. (e-mail: antoine.feydy{at}cch.aphp.fr).

View larger version (144K): [in a new window]   Figure 1a: Images of a 17-year-old woman with an osteosarcoma of the distal femur. The femoral artery was classified as free at surgery. (a) Transverse short inversion time inversion-recovery MR image (3100/15/150) shows a fat plane and muscle between the femoral artery (long arrow) and the tumor (short arrows). (b) Contrast-enhanced coronal MR angiographic image (6.3/1.5/27.0) shows a normal femoral artery (arrows) without stenosis. Note the slight bowing of the artery, which is probably caused by the tumor. On this image, there is a partial superimposition between the femoral artery and the femoral vein.

View larger version (104K): [in a new window]   Figure 1b: Images of a 17-year-old woman with an osteosarcoma of the distal femur. The femoral artery was classified as free at surgery. (a) Transverse short inversion time inversion-recovery MR image (3100/15/150) shows a fat plane and muscle between the femoral artery (long arrow) and the tumor (short arrows). (b) Contrast-enhanced coronal MR angiographic image (6.3/1.5/27.0) shows a normal femoral artery (arrows) without stenosis. Note the slight bowing of the artery, which is probably caused by the tumor. On this image, there is a partial superimposition between the femoral artery and the femoral vein.

View larger version (177K): [in a new window]   Figure 2a: Images of a 35-year-old woman with a chondrosarcoma of the proximal tibia. A releasable adhesion was found at surgery. (a) Transverse contrast-enhanced fast spin-echo fat-saturated T1-weighted MR image (460/14 msec) shows no fat plane between the posterior tibial artery (white arrow) and the tumor (black arrows). (b) Contrast-enhanced coronal MR angiographic image (6.3/1.5/27.0) shows a displacement of the posterior tibial artery (long arrows) without stenosis. Note the tumoral blush (short arrows). (c) Coronal angiographic image shows displacement of the posterior tibial artery (long arrows) without stenosis, which is in agreement with MR angiographic findings. Note the tumoral blush (short arrows).

View larger version (101K): [in a new window]   Figure 2b: Images of a 35-year-old woman with a chondrosarcoma of the proximal tibia. A releasable adhesion was found at surgery. (a) Transverse contrast-enhanced fast spin-echo fat-saturated T1-weighted MR image (460/14 msec) shows no fat plane between the posterior tibial artery (white arrow) and the tumor (black arrows). (b) Contrast-enhanced coronal MR angiographic image (6.3/1.5/27.0) shows a displacement of the posterior tibial artery (long arrows) without stenosis. Note the tumoral blush (short arrows). (c) Coronal angiographic image shows displacement of the posterior tibial artery (long arrows) without stenosis, which is in agreement with MR angiographic findings. Note the tumoral blush (short arrows).

View larger version (102K): [in a new window]   Figure 2c: Images of a 35-year-old woman with a chondrosarcoma of the proximal tibia. A releasable adhesion was found at surgery. (a) Transverse contrast-enhanced fast spin-echo fat-saturated T1-weighted MR image (460/14 msec) shows no fat plane between the posterior tibial artery (white arrow) and the tumor (black arrows). (b) Contrast-enhanced coronal MR angiographic image (6.3/1.5/27.0) shows a displacement of the posterior tibial artery (long arrows) without stenosis. Note the tumoral blush (short arrows). (c) Coronal angiographic image shows displacement of the posterior tibial artery (long arrows) without stenosis, which is in agreement with MR angiographic findings. Note the tumoral blush (short arrows).

View larger version (114K): [in a new window]   Figure 3a: Images of a 61-year-old man with a chondrosarcoma of the left iliac bone. The iliac artery was encased at surgery. (a) Transverse short inversion time inversion-recovery MR image (3100/15/150) shows partial encasement (arrow). (b) Transverse contrast-enhanced fast spin-echo fat-saturated T1-weighted MR image (460/14) shows partial encasement (arrow). (c) Coronal contrast-enhanced MR angiographic image (6.8/2.1/22.0) shows displacement of the iliac artery (arrow) without stenosis. (d) Coronal angiographic image shows displacement of the iliac artery (arrow) without stenosis; this finding is in agreement with MR angiographic findings.

View larger version (132K): [in a new window]   Figure 3b: Images of a 61-year-old man with a chondrosarcoma of the left iliac bone. The iliac artery was encased at surgery. (a) Transverse short inversion time inversion-recovery MR image (3100/15/150) shows partial encasement (arrow). (b) Transverse contrast-enhanced fast spin-echo fat-saturated T1-weighted MR image (460/14) shows partial encasement (arrow). (c) Coronal contrast-enhanced MR angiographic image (6.8/2.1/22.0) shows displacement of the iliac artery (arrow) without stenosis. (d) Coronal angiographic image shows displacement of the iliac artery (arrow) without stenosis; this finding is in agreement with MR angiographic findings.

View larger version (122K): [in a new window]   Figure 3c: Images of a 61-year-old man with a chondrosarcoma of the left iliac bone. The iliac artery was encased at surgery. (a) Transverse short inversion time inversion-recovery MR image (3100/15/150) shows partial encasement (arrow). (b) Transverse contrast-enhanced fast spin-echo fat-saturated T1-weighted MR image (460/14) shows partial encasement (arrow). (c) Coronal contrast-enhanced MR angiographic image (6.8/2.1/22.0) shows displacement of the iliac artery (arrow) without stenosis. (d) Coronal angiographic image shows displacement of the iliac artery (arrow) without stenosis; this finding is in agreement with MR angiographic findings.

View larger version (125K): [in a new window]   Figure 3d: Images of a 61-year-old man with a chondrosarcoma of the left iliac bone. The iliac artery was encased at surgery. (a) Transverse short inversion time inversion-recovery MR image (3100/15/150) shows partial encasement (arrow). (b) Transverse contrast-enhanced fast spin-echo fat-saturated T1-weighted MR image (460/14) shows partial encasement (arrow). (c) Coronal contrast-enhanced MR angiographic image (6.8/2.1/22.0) shows displacement of the iliac artery (arrow) without stenosis. (d) Coronal angiographic image shows displacement of the iliac artery (arrow) without stenosis; this finding is in agreement with MR angiographic findings.

View larger version (107K): [in a new window]   Figure 4a: Images of a 65-year-old woman with fibrosarcoma of the thigh. The femoral artery was encased at surgery. (a) Transverse short inversion time inversion-recovery MR image (3100/15/150) shows complete encasement of the femoral artery (long arrow) by the tumor (short arrows). (b) Coronal contrast-enhanced MR angiographic image (6.2/1.4/27.0) shows stenosis (arrow) of the femoral artery. (c) Coronal angiographic image shows arterial stenosis (arrow); this finding is in agreement with MR angiographic findings.

View larger version (89K): [in a new window]   Figure 4b: Images of a 65-year-old woman with fibrosarcoma of the thigh. The femoral artery was encased at surgery. (a) Transverse short inversion time inversion-recovery MR image (3100/15/150) shows complete encasement of the femoral artery (long arrow) by the tumor (short arrows). (b) Coronal contrast-enhanced MR angiographic image (6.2/1.4/27.0) shows stenosis (arrow) of the femoral artery. (c) Coronal angiographic image shows arterial stenosis (arrow); this finding is in agreement with MR angiographic findings.

View larger version (119K): [in a new window]   Figure 4c: Images of a 65-year-old woman with fibrosarcoma of the thigh. The femoral artery was encased at surgery. (a) Transverse short inversion time inversion-recovery MR image (3100/15/150) shows complete encasement of the femoral artery (long arrow) by the tumor (short arrows). (b) Coronal contrast-enhanced MR angiographic image (6.2/1.4/27.0) shows stenosis (arrow) of the femoral artery. (c) Coronal angiographic image shows arterial stenosis (arrow); this finding is in agreement with MR angiographic findings.