This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Walsh, M. Articles by Fessell, D. P. Search for Related Content PubMed PubMed Citation Articles by Walsh, M. Articles by Fessell, D. P.

Sonography of Fat Necrosis Involving the Extremity and Torso With Magnetic Resonance Imaging and Histologic Correlation

Departments of Radiology (M.W., J.A.J., S.M.K., Y.M., D.P.F.) and Pathology (D.R.L.), University of Michigan Medical Center, Ann Arbor, Michigan USA.

Address correspondence to Jon A. Jacobson, MD, Department of Radiology, University of Michigan Medical Center, 1500 E Medical Center Dr, TC-2910L, Ann Arbor, MI 48109-0326 USA. E-mail: jjacobsn{at}umich.edu

Objective. The purpose of this study was to describe the sonographic appearance of pathologically proven isolated fat necrosis involving the extremities or torso with magnetic resonance imaging (MRI) correlation. Methods. A query of the Department of Pathology database at our institution for the diagnosis of fat necrosis resulted in 1539 cases. Review of the cases and medical records excluded cases without sonographic imaging, those involving the breast, and those within or adjacent to a primary process, including masses or prior surgery, which resulted in a total of 5 cases of primary fat necrosis, 2 of which were evaluated with MRI. Sonograms were reviewed by 2 musculoskeletal radiologists and characterized with regard to location, echogenicity, shadowing, posterior through-transmission, a hypoechoic rim or halo, definition of borders, homogeneity, a mass effect, and vascularity. The patient medical records, histologic results, and MRI findings were also reviewed. Results. Of the 5 cases of isolated fat necrosis, 2 involved the torso and 3 the lower extremities. On sonography, all were located in the subcutaneous fat; 2 were isoechoic; 3 were hyperechoic; 2 had a hypoechoic halo; none showed shadowing or posterior through-transmission; 2 were well defined; 3 were masslike; 4 were heterogeneous; and 2 showed increased flow on color or power Doppler imaging. Magnetic resonance imaging showed an intermediate signal and either diffuse or ring enhancement. Conclusions. Isolated fat necrosis of the extremities and torso had 2 sonographic appearances, which included a well-defined isoechoic mass with a hypoechoic halo and a poorly defined hyperechoic region in the subcutaneous fat.

Key Words: fat • fat necrosis • soft tissues • sonography • subcutaneous

Abbreviations: MRI, magnetic resonance imaging • TE, echo time • TR, repetition time