Which MRI features favor a benign lipoma in soft tissue?

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Multiple Choice

Which MRI features favor a benign lipoma in soft tissue?

Explanation:
The key idea is that a benign lipoma is made of mature fat, so its MRI appearance should mirror fat itself. On T1-weighted images, fat is bright, and a lipoma typically shows a uniform, homogeneous high signal that matches subcutaneous fat. When you apply fat-saturation, fat signal is suppressed, and this lesion loses its brightness completely. That combination—bright on T1 with complete suppression on fat-sat—points to fat content without non-fat tissue, which is characteristic of a benign lipoma. In contrast, features like heterogeneous signal with thick internal septa or nodular non-fat components, strong enhancement after contrast, or irregular margins with solid non-fat tissue would raise concern for a liposarcoma or other malignancy, not a simple lipoma.

The key idea is that a benign lipoma is made of mature fat, so its MRI appearance should mirror fat itself. On T1-weighted images, fat is bright, and a lipoma typically shows a uniform, homogeneous high signal that matches subcutaneous fat. When you apply fat-saturation, fat signal is suppressed, and this lesion loses its brightness completely. That combination—bright on T1 with complete suppression on fat-sat—points to fat content without non-fat tissue, which is characteristic of a benign lipoma.

In contrast, features like heterogeneous signal with thick internal septa or nodular non-fat components, strong enhancement after contrast, or irregular margins with solid non-fat tissue would raise concern for a liposarcoma or other malignancy, not a simple lipoma.

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