Figure 2d. Lytic permeative pattern. (a) Lateral radiograph of a 56-year-old woman shows permeative changes within the distal femur. (b) Coronal T2-weighted image (repetition time msec/echo time msec = 3,000/90) shows high signal intensity within the marrow and associated soft-tissue masses (arrows). (c) Sagittal contrast material-enhanced T1-weighted image (600/30) shows areas of enhancement within the intramedullary lesion and a soft-tissue mass off the posterior aspect of the femur (arrow). (d) Lateral view obtained 6 years after irradiation and combination chemotherapy shows sclerotic changes related to therapy.