Schwannoma MRI: Difference between revisions

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==MRI==
==MRI==


Schwannomas have fairly predictable signal characteristics <ref name="pmid29279723">{{cite journal| author=Rosahl S, Bohr C, Lell M, Hamm K, Iro H| title=Diagnostics and therapy of vestibular schwannomas - an interdisciplinary challenge. | journal=GMS Curr Top Otorhinolaryngol Head Neck Surg | year= 2017 | volume= 16 | issue=  | pages= Doc03 | pmid=29279723 | doi=10.3205/cto000142 | pmc=5738934 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29279723  }} </ref> <ref name="pmid29937853">{{cite journal| author=Zou J, Hirvonen T| title="Wait and scan" management of patients with vestibular schwannoma and the relevance of non-contrast MRI in the follow-up. | journal=J Otol | year= 2017 | volume= 12 | issue= 4 | pages= 174-184 | pmid=29937853 | doi=10.1016/j.joto.2017.08.002 | pmc=6002632 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29937853  }} </ref><ref name="pmid27124066">{{cite journal| author=Jeong KH, Choi JW, Shin JE, Kim CH| title=Abnormal Magnetic Resonance Imaging Findings in Patients With Sudden Sensorineural Hearing Loss: Vestibular Schwannoma as the Most Common Cause of MRI Abnormality. | journal=Medicine (Baltimore) | year= 2016 | volume= 95 | issue= 17 | pages= e3557 | pmid=27124066 | doi=10.1097/MD.0000000000003557 | pmc=4998729 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27124066  }} </ref><ref name="pmid27366777">{{cite journal| author=Kleijwegt MC, van der Mey AG, Wiggers-deBruine FT, Malessy MJ, van Osch MJ| title=Perfusion magnetic resonance imaging provides additional information as compared to anatomical imaging for decision-making in vestibular schwannoma. | journal=Eur J Radiol Open | year= 2016 | volume= 3 | issue=  | pages= 127-33 | pmid=27366777 | doi=10.1016/j.ejro.2016.05.005 | pmc=4919314 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27366777  }} </ref> :
Schwannomas have fairly predictable signal characteristics <ref name="pmid29279723">{{cite journal| author=Rosahl S, Bohr C, Lell M, Hamm K, Iro H| title=Diagnostics and therapy of vestibular schwannomas - an interdisciplinary challenge. | journal=GMS Curr Top Otorhinolaryngol Head Neck Surg | year= 2017 | volume= 16 | issue=  | pages= Doc03 | pmid=29279723 | doi=10.3205/cto000142 | pmc=5738934 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29279723  }} </ref> <ref name="pmid29937853">{{cite journal| author=Zou J, Hirvonen T| title="Wait and scan" management of patients with vestibular schwannoma and the relevance of non-contrast MRI in the follow-up. | journal=J Otol | year= 2017 | volume= 12 | issue= 4 | pages= 174-184 | pmid=29937853 | doi=10.1016/j.joto.2017.08.002 | pmc=6002632 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29937853  }} </ref><ref name="pmid27124066">{{cite journal| author=Jeong KH, Choi JW, Shin JE, Kim CH| title=Abnormal Magnetic Resonance Imaging Findings in Patients With Sudden Sensorineural Hearing Loss: Vestibular Schwannoma as the Most Common Cause of MRI Abnormality. | journal=Medicine (Baltimore) | year= 2016 | volume= 95 | issue= 17 | pages= e3557 | pmid=27124066 | doi=10.1097/MD.0000000000003557 | pmc=4998729 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27124066  }} </ref><ref name="pmid27366777">{{cite journal| author=Kleijwegt MC, van der Mey AG, Wiggers-deBruine FT, Malessy MJ, van Osch MJ| title=Perfusion magnetic resonance imaging provides additional information as compared to anatomical imaging for decision-making in vestibular schwannoma. | journal=Eur J Radiol Open | year= 2016 | volume= 3 | issue=  | pages= 127-33 | pmid=27366777 | doi=10.1016/j.ejro.2016.05.005 | pmc=4919314 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27366777 }} </ref> <ref name="pmid28546250">{{cite journal| author=Lin EP, Crane BT| title=The Management and Imaging of Vestibular Schwannomas. | journal=AJNR Am J Neuroradiol | year= 2017 | volume= 38 | issue= 11 | pages= 2034-2043 | pmid=28546250 | doi=10.3174/ajnr.A5213 | pmc=5690865 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28546250 }} </ref>:
* '''T1''': isointense or hypointense
* '''T1''': isointense or hypointense
* '''T1 C+ (Gd)''': intense enhancement
* '''T1 C+ (Gd)''': intense enhancement

Revision as of 12:25, 22 October 2019

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

Overview

MRI

Schwannomas have fairly predictable signal characteristics [1] [2][3][4] [5]:

  • T1: isointense or hypointense
  • T1 C+ (Gd): intense enhancement
  • T2: heterogeneously hyperintense (Antoni A: relatively low, Antoni B: high)
    • cystic degenerative areas may be present, especially in larger tumors
  • T2*: larger tumors often have areas of hemosiderin

A number of signs can also be useful:

  • split-fat sign: thin peripheral rim of fat best seen on planes along long axis of the lesion in non-fat-suppressed sequences
  • target sign
    • peripheral high T2 signal
    • central low signal
    • rarely seen intracranially 7
  • fascicular sign: multiple small ring-like structures

References

  1. Rosahl S, Bohr C, Lell M, Hamm K, Iro H (2017). "Diagnostics and therapy of vestibular schwannomas - an interdisciplinary challenge". GMS Curr Top Otorhinolaryngol Head Neck Surg. 16: Doc03. doi:10.3205/cto000142. PMC 5738934. PMID 29279723.
  2. Zou J, Hirvonen T (2017). ""Wait and scan" management of patients with vestibular schwannoma and the relevance of non-contrast MRI in the follow-up". J Otol. 12 (4): 174–184. doi:10.1016/j.joto.2017.08.002. PMC 6002632. PMID 29937853.
  3. Jeong KH, Choi JW, Shin JE, Kim CH (2016). "Abnormal Magnetic Resonance Imaging Findings in Patients With Sudden Sensorineural Hearing Loss: Vestibular Schwannoma as the Most Common Cause of MRI Abnormality". Medicine (Baltimore). 95 (17): e3557. doi:10.1097/MD.0000000000003557. PMC 4998729. PMID 27124066.
  4. Kleijwegt MC, van der Mey AG, Wiggers-deBruine FT, Malessy MJ, van Osch MJ (2016). "Perfusion magnetic resonance imaging provides additional information as compared to anatomical imaging for decision-making in vestibular schwannoma". Eur J Radiol Open. 3: 127–33. doi:10.1016/j.ejro.2016.05.005. PMC 4919314. PMID 27366777.
  5. Lin EP, Crane BT (2017). "The Management and Imaging of Vestibular Schwannomas". AJNR Am J Neuroradiol. 38 (11): 2034–2043. doi:10.3174/ajnr.A5213. PMC 5690865. PMID 28546250.

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