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Fig 5. Lymphoma in a 33-year-old man. False-negative for malignancy.
A and B, T1- and T2-weighted images, respectively, done in February 2003 show abnormal decreased signal intensity (arrows) on the T1-weighted sequence and increased signal intensity (arrows) on the T2-weighted sequence compared with normal marrow. These findings were considered to be due to lymphomatous marrow infiltration.
C and D, In-phase image and opposed-phase image, respectively, done in February 2003. Signal intensity measurement is 202 on the in-phase sequence and 215 on the opposed phase, a ratio of 1.1 or a malignant result.
E–H, T1-weighted, T2-weighted, in-phase, and opposed-phase images 3 months later. Patient has received prior radiation therapy. T1- and T2-weighted images continue to show abnormal signal intensity relative to the normal marrow (arrows), though the signal intensity changes have evolved since the initial examination. Signal intensity on the in-phase image is 90 and 46 on the opposed-phase, a SIR of 0.51, a benign result in a lesion that was still considered malignant on the routine sequences.
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