Open AccessMRI Findings of Early Myositis Ossificans without Calcification or Ossification
Author(s) -
Hexiang Wang,
Pei Nie,
Yang Li,
Feng Hou,
Cheng Dong,
Yonghua Huang,
Dapeng Hao
Publication year - 2018
Publication title -
biomed research international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 126
eISSN - 2314-6141
pISSN - 2314-6133
DOI - 10.1155/2018/4186324
Subject(s) - calcification , medicine , ossification , myositis ossificans , magnetic resonance imaging , anatomy , lesion , pathology , heterotopic ossification , radiology
Purpose To characterize and evaluate the MR imaging features of early myositis ossificans (MO) without calcification or ossification.Methods The MRI manifestations of seven patients with pathologically proven early MO were retrospectively analyzed with regard to tumor location, size, margins, signal intensity, and enhancement appearance in MR images. Additionally, the surrounding soft-tissue edema and adjacent bone change were assessed.Results All cases (n=7) had intramuscular tumor-like masses without calcifications. The lesions appeared as isointense in T1-weighted images (T1-WI) and inhomogeneous hyperintense in T2-weighted MR images (T2-WI). On T2-WI and postcontrast T1-WI, the heterogeneously high signal intensity in the expanded muscle interspersed with a few hypointense linear structures consistent with intact muscle fibers showed “striate pattern” in the plane parallel with muscle fibers. The relatively hypointense areas with geometrical pattern consistent with the bundles of intact muscle fibers are found within the lesion with diffuse high signal intensity, displaying the “checkerboard-like pattern” in the plane vertical to muscle fibers. A “striate pattern” (n = 7) and “checkerboard-like pattern” (n = 3) in the lesion appeared in T2-WI. In contrast-enhanced MRI images, all cases showed diffuse “striate pattern” enhancement. Among them, one case demonstrated “checkerboard-like pattern” enhancement. All cases had diffuse and prominent muscle edema that preserved the muscle fascicles. For two lesions located in the deep muscle group, the adjacent bone showed bone marrow edema.Conclusion MR imaging has unique advantages for diagnosis of early MO without calcification or ossification: the “striate pattern” and “checkerboard-like pattern” appearance shown in T2-WI and contrast-enhanced MRI images can be helpful for differential diagnosis. MRI can delineate the extent of the tumor and provides accurate anatomical information, which is important in diagnosis, treatment, and follow-up.