Fig. 21

Angiosarcoma. Axial CT image in the bone window (a) demonstrates a large lytic lesion replacing the majority of the sacrum (orange arrow), with multiple areas of cortical erosion and destruction (white arrows). In the contrast-enhanced soft tissue window (b), enhancing areas are present within the mass, representing serpiginous vessels (black arrows). T2 weighted MR image (c) of the lumbosacral spine demonstrates a heterogeneous, destructive mass within the sacrum (orange arrows), with extension into the paraspinal soft tissues. The mass is low to intermediate signal on pre-contrast T1-weighted imaging (d). Post-contrast T1-weighted fat-suppressed image (e) demonstrates heterogeneous enhancement