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Microscopy Coil for Preoperative MRI of Small Soft-Tissue Masses of the Hand and Foot: Comparison with Conventional Surface Coil

In Sook Lee1,2,3, Jung-Ah Choi1,2, Joo Han Oh4, Jin-Haeng Chung5, Hee Sun Jeong1, Sung Hwan Hong2 and Heung Sik Kang1,2

1 Department of Radiology, Seoul National University Bundang Hospital, 300 Gumidong, Bundang-Gu, Seong Nam, Gyeongi-Do, 463-707 Korea.
2 Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea.
3 Present address: Department of Radiology, Pusan National University College of Medicine and Medical Research Institute, Pusan National University, Busan, Korea.
4 Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Gyeongi-Do, Korea.
5 Department of Pathology, Seoul National University Bundang Hospital, Gyeongi-Do, Korea.


Figure 1
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  		Fig. 1A —37-year-old woman with glomus tumor. T2-weighted MR image obtained with conventional surface coil (TR/TE, 3,246/100; field of view, 130 mm2; slice thickness, 3 mm; number of excitations, 3) shows mass is not visible.

 

Figure 2
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  		Fig. 1B —37-year-old woman with glomus tumor. Axial T2-weighted MR image obtained with microscopy coil (3,234/100; field of view, 80 mm2; slice thickness, 3 mm; number of excitations, 4) shows mass in nail bed (arrow) measuring approximately 1.6 mm in longest diameter.

 

Figure 3
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  		Fig. 2A —63-year-old woman with melanoma on sole. T2-weighted sagittal MR image obtained with conventional surface coil (TR/TE, 3,239/100; field of view, 250 mm2; slice thickness, 3 mm; number of excitations, 4) does not provide enough information for detection or definition of extent of mass (arrow).

 

Figure 4
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  		Fig. 2B —63-year-old woman with melanoma on sole. Sagittal T2-weighted MR image obtained with microscopy coil (2,500/80; field of view, 60 mm2; slice thickness, 1.5 mm; number of excitations, 4) shows small superficial mass (arrow) limited to dermis.

 

Figure 5
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  		Fig. 3A —55-year-old woman with neurofibroma. T1-weighted coronal MR image obtained with conventional coil (TR/TE, 441/20; field of view, 160 mm2; slice thickness, 3 mm; number of excitations, 2) shows only atrophy of interosseous muscles of first and second web spaces (arrows).

 

Figure 6
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  		Fig. 3B —55-year-old woman with neurofibroma. T2-weighted coronal MR image obtained with microscopy coil (3,032/100; field of view, 80 mm2; slice thickness, 2 mm; number of excitations, 2) shows bulbous enlargement of deep branch of ulnar nerve (arrows).

 

Figure 7
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  		Fig. 4A —51-year-old man with multiple giant cell tumors of tendon sheath. Photograph shows large protruding soft-tissue mass (3) around interphalangeal joint on radial side of thumb.

 

Figure 8
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  		Fig. 4B —51-year-old man with multiple giant cell tumors of tendon sheath. Serial axial T1-weighted images (TR/TE, 450/18) obtained with microscopy coil show five well-marginated nodular masses (1–5) with low signal intensity. Bone erosion by large mass at phalangeal bone is evident.

 

Figure 9
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  		Fig. 4C —51-year-old man with multiple giant cell tumors of tendon sheath. Serial axial T1-weighted images (TR/TE, 450/18) obtained with microscopy coil show five well-marginated nodular masses (1–5) with low signal intensity. Bone erosion by large mass at phalangeal bone is evident.

 

Figure 10
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  		Fig. 4D —51-year-old man with multiple giant cell tumors of tendon sheath. Serial axial T1-weighted images (TR/TE, 450/18) obtained with microscopy coil show five well-marginated nodular masses (1–5) with low signal intensity. Bone erosion by large mass at phalangeal bone is evident.

 

Figure 11
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  		Fig. 4E —51-year-old man with multiple giant cell tumors of tendon sheath. Photograph shows five yellowish and brown nodular masses (1–5) after surgical removal.

 

Figure 12
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  		Fig. 5A —40-year-old man with glomus tumor. Contrast-enhanced fat-suppressed T1-weighted coronal MR image obtained with conventional small surface coil (TR/TE, 417.1/20; field of view, 150 mm2; slice thickness, 3 mm; number of excitations, 2) seems to show one mass at fingertip area in nail bed (arrow).

 

Figure 13
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  		Fig. 5B —40-year-old man with glomus tumor. Contrast-enhanced fat-suppressed T1-weighted coronal image obtained with microscopy coil (655/24; field of view, 60 mm2; slice thickness, 1.5 mm; number of excitations, 2) shows two well-demarcated, well-enhanced lesions (arrows) at fingertip area in nail bed.

 

Figure 14
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  		Fig. 5C —40-year-old man with glomus tumor. Surgical photograph shows larger mass detected first.

 

Figure 15
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  		Fig. 5D —40-year-old man with glomus tumor. Surgical photograph shows second smaller mass found with further probing and excised.

 

Figure 16
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  		Fig. 5E —40-year-old man with glomus tumor. Photograph shows two excised glomus tumors. Final histopathologic diagnosis correlated with findings on MRI performed with microscopy coil.

 

Figure 17
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  		Fig. 6A —49-year-old woman with known squamous cell carcinoma confirmed at biopsy. Axial contrast-enhanced fat-suppressed T1-weighted MR image obtained with conventional surface coil (TR/TE, 495/20; field of view, 100 mm2; slice thickness, 3 mm; number of excitations, 6) shows precise depth of mass (arrow) cannot be assessed.

 

Figure 18
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  		Fig. 6B —49-year-old woman with known squamous cell carcinoma confirmed at biopsy. Axial contrast-enhanced fat-suppressed T1-weighted MR image obtained with microscopy coil (805/20; field of view, 80 mm2; slice thickness, 3 mm; number of excitations, 2) shows mass (arrow) confined to cutis and subcutis.

 

Figure 19
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  		Fig. 7A —37-year-old woman with giant cell tumor of tendon sheath of finger. Contrast-enhanced axial T1-weighted MR image obtained with conventional surface coil (TR/TE, 687.6/12; field of view, 120 mm2; slice thickness, 3 mm; number of excitations, 2) shows indistinct palmar digital nerve and artery displaced by mass (arrow).

 

Figure 20
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  		Fig. 7B —37-year-old woman with giant cell tumor of tendon sheath of finger. MR image obtained with microscopy coil (780.8/22; field of view, 60 mm2; slice thickness, 1.5 mm; number of excitations, 2) clearly depicts mass (arrow) compressing and laterally displacing palmar digital nerve and artery on ulnar side.

 

Figure 21
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  		Fig. 7C —37-year-old woman with giant cell tumor of tendon sheath of finger. Surgical photograph shows relation between mass and tendon and good correlation with neurovascular bundle.

 

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