Evaluation of Role of Magnetic Resonance Imaging in Detection and Characterization of Soft Tissue Masses of the Hand and Wrist

Abstract Background: The wrist and hand joints are complex structures with an extensive differential diagnosis for a pre-senting mass. However, the vast majority of wrist and hand masses are benign. Magnetic Resonance Imaging (MRI) by virtue of its ability to provide detailed soft tissue characteri-zation is the preferred method of imaging the problematic soft tissue masses. Aim of Study: To evaluate the role of MRI in diagnosis of the most commonly encountered soft tissue masses of the wrist and hand, describing their main features; specifically the signal characteristics and location that helps to differentiate them. Methods: This cross section study included 42 patients (22 females and 20 males), their ages range between 1 year and 79 years, with mean age of 32.24 year. The study was performed in Radiology Department El-Demerdash Hospital between March 2018 and September 2019. Results: Benign and malignant lesions represented (97.6%) and (2.4%) respectively of the encountered lesions. The most commonly found lesions were ganglia (33.3%). The most frequently seen solid tumors, included Giant Cell Tumor of the Tendon Sheath (GCTTS) (9.5%), benign Nerve Sheath Tumors (NST) (4.8%), lipoma (2.4%), hemangioma (4.8%)/ vascular malformation (9.5%), fibroma of the nerve (4.8%) and malignant lesions (2.4%). Joint and soft tissue infection were encountered in (2.4%) of cases. A specific diagnosis was made, or strongly suspected, from the MRI features found in certain conditions like ganglion, hemangioma, arteriovenous malformation, giant cell tumor of the tendon sheath, lipoma, fibroma, and soft tissue infections. MR imaging of the wrist and hand provides a wealth of information regarding the status of and the relationship of the osseous and soft tissue compo-nents, both of which are necessary to confirm the clinical diagnosis and manage the patient in the most efficient way possible. Conclusion: Magnetic resonance imaging is the imaging method of choice for evaluating the presence and extent of soft tissue masses. It is particularly useful for assessing masses in the wrist and hand, where lesions are predominantly benign.
By noting the signal characteristics and determining the lesion location, a specific diagnosis of the mass can often be made. unfortunately, when lesion doesn't exhibit typical features, differentiation from malignancy can't be categorically made.