MRI Supplemented with Diffusion Weighted Image in Characterization of Soft Tissue Masses of the Wrist and Hand

Abstract

Background: The wrist joint is considered to be a condyloid synovial joint of the distal upper limb that connects and serves as a transition point between the forearm and hand. Hand and wrist soft tissue masses comprise a special subset of soft tissue masses. MRI imaging has an important role in characterization of soft tissue tumors, yet, it lacks specificity for differentiation between benign and malignant lesions.Diffusion-weighted imaging (DWI) is a non-invasive method for investigation of tumor histological content and used for differentiation between benign and malignant masses. Aims: This study aimed at assessment of the role of MR diffusion Weighted imaging (DWI) in the evaluation of soft tissue masses of the wrist and hand. Patients and Methods: This study conducted on 30 patients with soft tissue masses of the wrist and hand. They were referred from Orthopedic and Physiotherapy Departments to MRI unit in Radio-diagnosis Department, Tanta University Hospital. The study was conducted from November 2018 to November 2019. MRI with DWI was conducted for each one of them and results were correlated with histopathological examination. Results: There is a significant difference in the mean ADC value between benign and malignant soft tissue tumors. Increased apparent diffusion coefficient (ADC) values represent an increase in extracellular water or loss of cell membrane integrity whereas decreased ADC values reflect decrease in extracellular water content or increase in cell number or size. Conclusions: this study proved the role of MRI and supplementary Diffusion weighted image (DWI) with numerical ADC values in characterization of soft tissue masses of the wrist and hand.