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MRI EVALUATION OF MUSCULOSKELETAL TUMOURS AND ITS CORRELATION WITH HISTOPATHOLOGICAL EXAMINATION

BACKGROUND Medical imaging revolutionized both diagnostic and therapeutic approaches in musculoskeletal oncology by providing accurate information about the tissue composition and the anatomical relationships of musculoskeletal tumours that is used in tumour detection, staging, therapeutic monitoring, and post therapy surveillance. Radiographs provide critical information regarding lesion location, margin, matrix, mineralisation, cortical involvement and adjacent periosteal reaction. We wanted to determine the role of Magnetic Resonance Imaging in prospective evaluation of patients with clinical suspicion of musculoskeletal tumours. It’s relevance as an investigative modality in musculoskeletal tumours and to correlate the findings with final diagnosis by histopathological results. METHODS Prospective diagnostic study conducted with a sample size of 40 suspected musculoskeletal tumour cases in the department of radio-diagnosis, Rajarajeswari Medical College using Siemens Avento 1.5T MRI machine. Both plain radiograph & Magnetic Resonance Imaging evaluation were done & further diagnosis was confirmed by histopathological examination. All patients presenting with localized swelling were included in the study. Histopathology/FNAC is a mandatory criterion as proof for final diagnosis. Patients with generalized oedema, presenting with recurrence of a primary lesion and patients in whom MRI was contraindicated e.g.: with pacemakers, metallic implants, were excluded. For the initial evaluation of musculoskeletal tumours, radiographs should be the first line of imaging, as they are relatively inexpensive. It helps in diagnosis, separating benign from malignant cases and helps in deciding the requirement of additional imaging examination by Magnetic Resonance Imaging. Soft tissue-, joint- & neurovascular-involvement is better evaluated by MRI & helps to a greater extent in planning the course of treatment. A combination of Radiography & Magnetic Resonance Imaging evaluation gives accurate & all-round information regarding the musculoskeletal tumours, increasing the sensitivity & specificity to a much higher extent than if done individually.