Neurofibroma MRI: Difference between revisions

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==Overview==
==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]] 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
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| style="background:#DCDCDC;" align="center" + |'''T1'''
| style="background:#DCDCDC;" align="center" + |'''[[T1]]'''
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* 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'''
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* 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]]
|-
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| style="background:#DCDCDC;" align="center" + |'''T1 C+ (Gd) (with gadolinium contrast)'''
| style="background:#DCDCDC;" align="center" + |'''[[T1]] C+ (Gd) (with [[gadolinium]] [[contrast]])'''
|
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* Heterogenous enhancement
* Heterogenous enhancement
|}
[[File:Mri submand gif.gif|thumb|300px|none|Plexiform neurofibroma of the submandibular gland in patient with von Recklinghausen's disease. The MRI T-2 weighted image with contrast (A. Axial & B. Coronal view) showed a mass with diffuse heterogeneous enhancement in the left submandibular gland. [https://openi.nlm.nih.gov/detailedresult?img=PMC3070454_rt-2011-1-e4-g003&query=&req=4 Source: Bisher HA. et al, General Surgery Department, King Fahd Hospital of the University, Al Khobar, Saudi Arabia]]]
{|
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[[File:Sagittal mri.jpeg|thumb|300px|none|Plexiform Neurofibroma of the Bladder. Sagittal, T2-weighted MR image shows that the mass contains multiple areas of low signal intensity centrally and high signal intensity peripherally (arrow). This finding is referred to as the target sign and is suggestive of plexiform neurofibroma. [https://pubs.rsna.org/doi/10.1148/rg.24si035170#F1A Source: Wilkinson LM. et al, From the Department of Medical Imaging, Hospital for Sick Children, Toronto, Ontario, Canada.]]]
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[[File:Mri gd gif.gif|thumb|300px|none|Plexiform Neurofibroma of the Bladder. Axial unenhanced MR image shows mild nonuniform enhancement of the large bladder mass.[https://pubs.rsna.org/doi/10.1148/rg.24si035170#F1A Source: Wilkinson LM. et al, From the Department of Medical Imaging, Hospital for Sick Children, Toronto, Ontario, Canada.]]]
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[[File:Enhanced gd gif.gif|thumb|300px|none|Plexiform Neurofibroma of the Bladder.Axial gadolinium-enhanced MR image shows mild nonuniform enhancement of the large bladder mass. Source: Wilkinson LM. et al, From the Department of Medical Imaging, Hospital for Sick Children, Toronto, Ontario, Canada.]]]
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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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