Neurofibroma MRI: Difference between revisions

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{{CMG}}; {{AE}}{{S.M.}} {{SC}}
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==Overview==
==Overview==
[[MRI]] may be helpful in the diagnosis of neurofibroma.  
[[MRI]] may be helpful in the [[diagnosis]] of [[neurofibroma]]. It [[Appearance|appears]] as a hypointense, [[homogeneous]] low [[Signal (biology)|signal]] [[intensity]] [[lesion]] with center demonstrating a higher [[Signal (biology)|signal]] [[intensity]] than the [[periphery]] on [[T1]]. T2 [[Weighted mean|weighted]] [[images]] show hyperintense, [[homogeneous]] [[lesion]] with positive [[Target cell|target]] [[Sign (medicine)|sign]] and [[Fascicle|fascicular]] [[Sign (medicine)|sign]]. Moreover, [[Neurofibroma|neurofibromas]] have [[heterogeneous]] enhancement on [[T1]] C+ (Gd) (with [[gadolinium]] [[contrast]]).  


==MRI==
==MRI==
* [[MRI]] may be helpful in the diagnosis of neurofibroma
* [[MRI]] may be helpful in the [[diagnosis]] of [[neurofibroma]]
* MRI signal characteristics include:<ref name="radio">Neurofibroma.Dr Bruno Di Muzio and Dr Maxime St-Amant et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/neurofibroma Accessed on November 17, 2015 </ref><ref>https://pubs.rsna.org/doi/10.1148/rg.24si035170#REF8</ref>
* [[Magnetic resonance imaging|MRI]] [[Signal (biology)|signal]] characteristics include:<ref name="radio">Neurofibroma.Dr Bruno Di Muzio and Dr Maxime St-Amant et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/neurofibroma Accessed on November 17, 2015 </ref><ref>https://pubs.rsna.org/doi/10.1148/rg.24si035170#REF8</ref>
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! style="background:#4479BA; color: #FFFFFF;" align="center" + |Characteristics
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Characteristics
|-
|-
|style="background:#DCDCDC;" align="center" + |'''T1'''
| style="background:#DCDCDC;" align="center" + |'''[[T1]]'''
|
|
* Hypointense
* Hypointense
* Homogeneous low signal intensity
* [[Homogeneous]] low [[Signal (biology)|signal]] [[intensity]]
* Center demonstrating a higher signal intensity than the periphery (reverse of target sign on T2)
* Center demonstrating a higher [[Signal (biology)|signal]] [[intensity]] than the [[periphery]] (reverse of [[Target cell|target]] [[Sign (medicine)|sign]] on T2)
|-
|-
|style="background:#DCDCDC;" align="center" + |'''T2'''
| style="background:#DCDCDC;" align="center" + |'''T2'''
|
|
* Hyperintense
* Hyperintense
* Homogeneous high signal intensity (higher than fat)  
* [[Homogenous|Homogeneous]] high [[Signal (biology)|signal]] [[intensity]] (higher than [[fat]])  
* Target sign (plexiform neurofibromas)  
* [[Target cell|Target]] [[Sign (medical)|sign]] ([[Plexiform neurofibroma|plexiform neurofibromas]])  
** Low signal intensity centrally with a ring of high signal intensity peripherally
** Low [[Signal (biology)|signal]] [[intensity]] [[Central|centrally]] with a ring of high [[Signal (biology)|signal]] [[intensity]] peripherally
** Due to a dense central area of collagenous stroma
** Due to a [[dense]] [[central]] [[area]] of [[collagenous]] [[stroma]]
** Highly suggestive of neurofibroma but occasionally also seen in schwannomas and malignant peripheral nerve sheath tumors
** Highly suggestive of [[neurofibroma]] but occasionally also seen in [[schwannomas]] and [[Malignant peripheral nerve sheath tumor|malignant peripheral nerve sheath tumors]]
* Fascicular sign  
* [[Fascicle|Fascicular]] [[Sign (medical)|sign]]
* Plexiform neurofibromas may appear as a larger and more infiltrating mass with lobulated borders with inhomogeneous enhancement  
* [[Plexiform neurofibroma|Plexiform neurofibromas]] may [[Appearance|appear]] as a larger and more [[Infiltration (medical)|infiltrating]] [[mass]] with [[Lobular|lobulated]] [[Borderline|borders]] with inhomogeneous enhancement  
* Myxoid stroma enhancement helps differentiating the high signal intensity at T2-weighted imaging from cystic change or necrosis  
* Myxoid [[stroma]] enhancement helps differentiating the high [[Signal (biology)|signal]] [[intensity]] at T2-[[Weighted mean|weighted]] [[imaging]] from [[cystic]] change or [[necrosis]]
|-
|-
|style="background:#DCDCDC;" align="center" + |'''T1 C+ (Gd) (with gadolinium contrast)'''
| style="background:#DCDCDC;" align="center" + |'''[[T1]] C+ (Gd) (with [[gadolinium]] [[contrast]])'''
|
|
* Heterogenous enhancement
* Heterogenous enhancement

Latest revision as of 16:02, 26 May 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mohsin, M.D.[2] Shanshan Cen, M.D. [3]

Overview

MRI may be helpful in the diagnosis of neurofibroma. It appears as a hypointense, homogeneous low signal intensity lesion with center demonstrating a higher signal intensity than the periphery on T1. T2 weighted images show hyperintense, homogeneous lesion with positive target sign and fascicular sign. Moreover, neurofibromas have heterogeneous enhancement on T1 C+ (Gd) (with gadolinium contrast).

MRI

MRI sequence Characteristics
T1
T2
T1 C+ (Gd) (with gadolinium contrast)
  • Heterogenous enhancement

References

  1. Neurofibroma.Dr Bruno Di Muzio and Dr Maxime St-Amant et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/neurofibroma Accessed on November 17, 2015
  2. https://pubs.rsna.org/doi/10.1148/rg.24si035170#REF8


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