Radiology, Vol 195, 413-417, Copyright © 1995 by Radiological Society of North America
Soft-tissue sarcomas: MR imaging findings after treatment in three pediatric patients
LA Mullen, WE Berdon, C Ruzal-Shapiro, TL Levin, KS Fountain and JH Garvin
Department of Radiology, Babies Hospital, Columbia Presbyterian Medical Center, New York, NY 10032, USA.
PURPOSE: To characterize the skeletal and bone marrow magnetic resonance
(MR) imaging changes during and after treatment of childhood soft-tissue
tumors. MATERIALS AND METHODS: Three boys with soft-tissue sarcomas of the
popliteal fossa underwent surgery, radiation therapy, and chemotherapy.
Plain radiographic and MR imaging findings were correlated with the effect
of treatment. RESULTS: After radiation therapy, MR images revealed findings
that resembled those of rickets at sites of irradiation in the three
patients. These findings included metaphyseal sclerosis, metaphyseal
fraying, and epiphyseal plate widening. Bone marrow imaging changes were
temporally related to therapy. During chemotherapy, reconversion to
hematopoietic marrow was noted in nonirradiated areas in two patients, but
after cessation of all treatment, these areas converted back to fatty
marrow. Irradiated areas of bone marrow remained fatty throughout therapy
in the three patients. CONCLUSION: Awareness of the MR imaging findings
related to antineoplastic treatment of soft-tissue tumors is important to
distinguish these changes from progression of primary disease.
