Fibroma MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

MRI may be helpful in the diagnosis of fibroma. On MRI, fibromas appear isointense or hypointense on T1 sequences and hyperintense on T2 sequences.

MRI Findings

MRI component	Features
T1	Fibromas usually demonstrate homogeneous low signal intensity
T2	Fibromas appear as well-circumscribed masses with low signal intensity May contain scattered hyperintense areas representing oedema or cystic degeneration A band of T2 hypointensity separating the tumour from the uterus on all imaging planes is also considered a characteristic feature
T1 contrast + gadolinium	Usually shows heterogenous enhancement

Non-ossifying Fibroma

• MRI appearances of non-ossifying fibroma are variable and depends on when along the development and healing phase the lesion is imaged. Initially, the lesion has high or intermediate T2 signal, with a peripheral low signal rim corresponding to the sclerotic border. As it matures and begins to ossify, the signal becomes low on all sequences.

Contrast enhancement is also variable.

Ossifying Fibroma

MRI findings of ossifying fibroma includes the following:

• T1: low signal
• T2: iso-high signal
• T1 C+ (Gd): typically shows enhancement

Chondromyxoid Fibroma

MRI features of chondromyxoid fibromas are often not particularly specific. Signal characteristics include the following:

• T1: low signal
• T1 C+ (Gd)
  • The majority (~70%) tend to show peripheral nodular enhancement
  • Approximately 30% have diffuse contrast enhancement and this can be either homogeneous or heterogeneous
• T2: high signal

Desmoplastic Fibroma

There is considerable overlap with other bony lesions on MRI appearances of desmoplastic fibroma. Signal characteristics include the following:

• T1: typically low signal
• T2: has background intermediate to high signal with intrinsic low to intermediate intensity foci within 7
• T1 C+ (Gd): often shows heterogeneous enhancement

Cardiac Fibromas

Because of their dense, fibrous nature, the tumors are usually homogeneous and hypointense on T2-weighted MR images and isointense relative to muscle on T1-weighted images. Cardiac fibromas often demonstrate little or no contrast material enhancement.

Pleural Fibromas

Due to the fibrous component, signal characteristics tend to include the following:

• T1: typically low to intermediate signal
• T2: typically low signal overall (thought to be due to high cellularity and abundant collagen); areas of necrosis and myxoid degeneration can have high signal
• MRI may also show necrotic, haemorrhagic and cystic components in better detail if these entities are present.

References

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