Magnetic resonance imaging in differential diagnosis lipomas and liposarcomas of soft tissues

Relevance. Over the past 5 years, the incidence of soft tissue liposarcomas, including their localization in the extremities, has remained at the same level and amounts to 1 case per 100 thousand people per year. Despite this, liposarcoma is characterized by a high risk of recurrence and metastasis, which necessitates multidisciplinary treatment for each of them. The diagnosis of these malignant neoplasms remains complex due to their morphological diversity and pronounced similarity to benign lipomas, even with the improvement of radiation imaging methods.

The aim: To identify the semiotic characteristics of lipomas and liposarcomas according to multi-parametric magnetic resonance imaging, allowing these histological types of tumors to be differentiated from each other.

Materials and methods. The study included 75 patients with histologically verified lipomatous tumors of soft tissues (28 men and 47 women) aged from 30 to 82 years (average age 58 years). All patients underwent multiparametric MRI of soft tissues before treatment on a tomograph with a magnetic field strength of 1.5 T.

Results. The study included 32 patients with histologically verified liposarcoma and 43 patients with soft tissue lipoma. Morphologically, liposarcoma was represented by the following types: atypical lipomatous tumor (ALT/WDLS), dedifferentiated liposarcoma (DDLPS), myxoid liposarcoma (MLPS), pleomorphic liposarcoma (PLPS). The study identified a number of MR criteria that distinguish lipomas and liposarcomas from each other (tumor shape, location of the tumor relative to the compartment, number and thickness of septa, presence of solid tissue, MR signal on IP with suppression of the signal from adipose tissue (p < 0.05).

Conclusion. MRI allows not only to detect lipomatous tumors, but also to differentiate benign lipomas from malignant liposarcomas based on their morphological characteristics. This makes MRI an indispensable tool in the diagnosis and treatment planning of such tumors.

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