Desmoid tumor MRI

Desmoid tumor Microchapters
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Case #1

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sara Mohsin, M.D.[2]Faizan Sheraz, M.D. [3]

Overview

MRI is preferred over CT, especially for truncal and extremity desmoid tumors. On MRI, desmoid tumor has variable characteristics depending on their cellularity and fibrous content with loss of signal following fat saturation. They appear isointense/hypointense on T1 and hyperintense on T2.

MRI

• MRI is required in order to:
  • Define the relationship of the tumor to adjacent structures
  • Assess resectability
  • Find out the need for treatment
  • Monitor recurrence after surgery
• MRI is preferred over CT, especially for truncal and extremity tumors
• MRI characteristics of desmoid tumors are variable depending on their cellularity and fibrous content:

MRI characteristics of desmoid tumors

MRI sequence	Characteristics
T1	Homogeneously isointense Hypointense Mildly hyperintense Low intensity signal
T1 C+ (Gd)	Typically enhances avidly
T2/STIR	High heterogeneous signal Predominantly hyperintense (T2 hyperintensity may diminish over time as tumor cellularity decreases and collagen deposition increases) Hypointense bands may be seen that represent dense collections of collagen bundles With gadolinium administration Desmoids typically show moderate to marked enhancement Hypointense bands may become more apparent because collagen bundles are not enhanced by contrast material
GE	Peripheral areas of smooth low signal intensity that do not represent calcification or hemorrhage are characteristic

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  MRI of desmoid tumor