Hi,
64 y/o male. Incidental sclerotic lesion posterior right ilium on prior CT from 11/2020. Prostate check-up has yet to happen.
Current exam DIXON sequence.
The lesion looks suspicious to me on CT, so irregular, almost moth eaten appearance.
What is the DIXON telling me? I have seen prostate mets so sclerotic without any bone marrow signal coming through. I also don’t know where the right paravertebral muscle edema is coming from. The facet joints certainly don’t look good and CT also shows bilateral degenerative spondylolysis but could it also be related to the lesion?
Do you think hemangioma is still in the DDx?
Thx.
Best,
Björn
I received 4 responses that could not vary more in DDx.
1 x suspicious, biopsy recommended
1 x suspicious, bone scan recommended
1x Paget
1x hemangioma (Opp phase shows signal loss = intralesional fat)
I decided to state my remaining concerns about this lesion in the conclusion, as I am not yet convinced that it’s a hemangioma because I find the sclerosis quite dense and atypical for hemangioma and I have seen the DIXON opp-phase signal not being as certain in areas of sclerosis.
Björn
Sent: 17 March 2021 16:01
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Hi,
64 y/o male. Incidental sclerotic lesion posterior right ilium on prior CT from 11/2020. Prostate check-up has yet to happen.
Current exam DIXON sequence.
The lesion looks suspicious to me on CT, so irregular, almost moth eaten appearance.
What is the DIXON telling me? I have seen prostate mets so sclerotic without any bone marrow signal coming through. I also don’t know where the right paravertebral muscle edema is coming from. The facet joints certainly don’t look good and CT also shows bilateral degenerative spondylolysis but could it also be related to the lesion?
Do you think hemangioma is still in the DDx?
Thx.
Best,
Björn