ABSTRACT
Chronic expanding organizing hematoma (CEH) occasionally mimics a soft tissue tumor on MRI, which becomes more problematic in patients with a history of surgical resection for musculoskeletal malignancy. Herein, we present a case of CEH which we were able to differentiate from recurrent tumor through MRI follow-up, including diffusion-weighted imaging (DWI) and dynamic contrast enhanced (DCE) imaging. A 66-year-old male visited our institution under suspicion of recurrent leiomyosarcoma of the thigh, 19 months after surgery and radiation therapy. Due to inconclusive results, three US-guided biopsies and 6 MRI examinations were performed over 2 years. In the end, we could diagnose a CEH using conventional and functional MRI techniques, and it was histopathologically confirmed after surgical resection. A CEH may occur remotely after an initiating event, and it may persist and expand over several years. Functional MR sequences, in addition to conventional sequences, are helpful in differentiating CEH from malignant neoplasms.
Subject(s)
Aged , Humans , Male , Biopsy , Follow-Up Studies , Hematoma , Leiomyosarcoma , Magnetic Resonance Imaging , ThighABSTRACT
To develop an advanced non-linear curve fitting (NLCF) algorithm for performing dynamic susceptibility contrast study of the brain. The first pass effects give rise to spuriously high estimates of Ktrans for the voxels that represent the large vascular components. An explicit threshold value was used to reject voxels. The blood perfusion and volume estimation were accurately evaluated in the T2*-weighted dynamic contrast enhanced (DCE)-MR images. From each of the recalculated parameters, a perfusion weighted image was outlined by using the modified non-linear curve fitting algorithm. The present study demonstrated an improvement of an estimation of the kinetic parameters from the DCE T2*-weighted magnetic resonance imaging data with using contrast agents.