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Fig. 1 —58-year-old man with palpable right thigh softtissue mass in whom imaging-guided percutaneous biopsy with needle aspiration and core biopsies revealed myofibroblastic lesion of uncertain malignant potential, possibly representing fibromatosis, schwannoma, or low-grade sarcoma (although low-grade sarcoma was favored by histology). MRI and MR spectroscopy of right thigh mass are shown, with MR spectroscopy results highly favoring malignancy. Final pathology (Figs. 1F, 1G, 1H, 1I) after resection showed low-grade sarcoma.

A, Coronal inversion recovery STIR image (TR/TE, 2,462/100; inversion time, 200 milliseconds) of right thigh shows ovoid heterogeneous mass.

B, Coronal spin-echo T1-weighted image (690/15) of right thigh shows same mass for comparison.

C, Axial gradient-recalled echo contrast-enhanced T1-weighted image (8.7/4.3; flip angle, 90°) shows that mass enhances after contrast administration.

D, Axial fast spin-echo T2-weighted image (2,886/100) shows mass with placement of 2 x 2 x 2 mL voxel over lesion.

E, Corresponding single-voxel point-resolved spectroscopy MR spectroscopy (2,000/144) shows discrete choline (Cho) peak in lesion, with choline signal-to-noise ratio of 18.6, indicating malignancy.