Benign and malignant musculoskeletal lesions: dynamic contrast-enhanced MR imaging--parametric "first-pass" images depict tissue vascularization and perfusion.

Abstract

To assess the diagnostic value of parametric magnetic resonance images that display the first pass (FP) of gadopentetate dimeglumine. Dynamic, contrast material-enhanced, fast low-angle shot MR imaging was performed of 100 musculoskeletal lesions in 36 female and 64 male patients (aged 9-81 years [mean, 34 years]). The highest slope value of the time-intensity curve was calculated pixel by pixel and displayed on the FP image, with a gray-scale value equal to the slope value. Tissue vascularization and perfusion were evaluated at pathologic and angiographic examinations in 33 lesions. A significant difference (P < .001) was found between the FP slope values of benign (mean, 36.2% per second) and malignant (mean, 67.4% per second) lesions. FP images depicted tissue vascularization and perfusion rather than benignity or malignancy, because there is an overlap in the slope values of highly vascular benign lesions and malignant lesions. FP images provide diagnostically useful information by depicting tissue vascularization and perfusion.