Learning objectives
1.
Discuss different imaging modalities used to characterize fat-containing lesions (ultrasound,
CT and MRI)
2.
To review intra-abdominal fatty neoplastic lesions in US,
CT and MRI
3.
To provide a radiologic-pathologic correlation for some of these entities
4.
To serve as a learning tool for radiology trainees
Background
The identificationof fat within a lesion substantially reduces the number of entities to be considered in the differential diagnosis.
However,
these fat-containing lesions range from completely benign lipoma to high-grade sarcoma.
Because of these variations in biologic behavior,
radiologic and pathologic evaluation is crucial to refine diagnostic options and direct patient care.
Findings and procedure details
Appearances of fat on different imaging modalities
On ultrasound (US) images,fat tissues usually appear hyperechoic.
However,
there are exceptions and this technique is nonspecific and with limited sensitivity in the detection of fat.
On computed tomography (CT), fat appears to have low attenuation with a range of -10 to -100 Hounsfield units (HUs).
Identification of macroscopic fat is usually simple,
however if the proportion of fat within a voxel is small,
then the mean CT number will increase and fat may be difficult to identify....
Conclusion
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The presence of fat components within a lesion combined with other imaging features allow definite diagnosis or greatly narrow the differential diagnosis.
MRI is currently the most specific imaging technique for demonstration and characterization of microscopic and macroscopic fat.
Understanding and recognizing the spectrum of radiologic appearances and pathologic basis of fat containing lesions helps to refine the diagnostic options and treatment.
References
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Shin,
Na-Young,
et al.
“The Differential Imaging Features of Fat-Containing Tumors in the Peritoneal Cavity and Retroperitoneum: the Radiologic-Pathologic Correlation.”Korean Journal of Radiology,
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333.,
doi:10.3348/kjr.2010.11.3.333.
Smith,
Alice Boyd,
et al.
“From the Archives of the AFIP: Lesions of the Pineal Region: Radiologic-Pathologic Correlation.”RadioGraphics,
vol.
30,
no.
7,
2010,
pp.
2001–2020.,
doi:10.1148/rg.307105131.
Basaran,
Ceyla,
et al.
“Fat-Containing Lesions of the Liver: Cross-Sectional Imaging Findings with Emphasis on MRI.”American Journal of Roentgenology,
vol....