Magnetic resonance imaging of soft-tissue tumors of the extremities: A practical approach

Diagnosis of extremity soft-tissue tumors can be challenging. Characteristics of tumor margins can help precisely identify locally aggressive or non-aggressive behavior for surgical planning, but cannot differentiate benign from malignant lesions. Most malignant tumors can have inhomogeneous signals on T2-weighted images. Although a uniform signal on T2-weighted images can be a reliable indication of a benign lesion, a well-defined mass with homogeneous internal signal intensity does not definitively identify a benign lesion. Some common and distinctive soft-tissue lesions can have specific clinical and imaging features allowing a diagnosis without biopsy. These are known as determinate lesions. This illustrative report presents a diagnostic guide for extremity soft-tissue tumors based on tissue signal and morphological characteristics on magnetic resonance images. It is important for clinicians to be familiar with the imaging characteristics of common determinate lesions.