MRI RIGHT KNEE AND RIGHT LEG HISTORY: Known case of lymphoma S P CMT x 3 cycles. STUDY DATE: Oct 14, 2015 COMPARISON STUDY No previous plain film or MRI for comparison. TECHNIQUES: The study was performed on axial, sagittal and coronal on T1W, T2W and TIW/GD/FS of TSE. Additional of coronal view on T2W/STIR/TSE and T2W/FFE images was also obtained FINDINGS: The study reveals two lesions of bony destruction as follow The first one located at metaphysis with epiohysis of medial aspect of proximal right
FINDINGS: The study reveals two lesions of bony destruction as follow The first one located at metaphysis with epiohysis of medial aspect of proximal right tibia with surrounding soft tissue abnormal signal intensity of the muscles of right leg and right knee invasion which was measures about 5.3x6x6.3 cm. (WxAPxH). With MRI, this lesion shows some portions of high signal on TIW and T2W with intense enhancement on post gadolinium images and cannot be suppressed by fat saturation images. So the hypervascularity of this component is considered. Some cystic composition of the lesion is seen. However, no definite multiple signal voding indicated new bone or osteoid formation. Correlation with plain film is advised. There is no cystic composition within the mass The second lesion is located at medial aspect of metaphysis of distal femur with no soft cm. (WxAPxH). With MRI, this lesion shows some 7 tissue involvement about 1.6 portions of high signal on T 1w and T2W with intense enhancement on post gadolinium images and cannot be suppressed by fat saturation images. No cystic composition is seen within this lesion All these findings are compatible with multiple active lesion of marrow replacement more favored bone metastases or multiple bone involvement of lymphoma
IMPRESSION: Two lesions of abnormal bony destruction as described in detail above more favored bone metastases or multiple bone involvement of lymphoma is considered Comparison with plain film and bone scan are advised. Kullanuch Chanchairujira, M.D