Schwannoma MRI: Difference between revisions
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{{CMG}}; {{AE}};{{M.N}} | {{CMG}}; {{AE}};{{M.N}} | ||
==Overview== | ==Overview== | ||
Schwannomas appear on T1 as 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. Signs can also be useful in diagnosing such as 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, fascicular sign: multiple small ring-like structures. | |||
==MRI== | ==MRI== | ||
Schwannomas have fairly predictable signal characteristics | 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><ref name="pmid25621227">{{cite journal |vauthors=Singh K, Singh MP, Thukral C, Rao K, Singh K, Singh A |title=Role of magnetic resonance imaging in evaluation of cerebellopontine angle schwannomas |journal=Indian J Otolaryngol Head Neck Surg |volume=67 |issue=1 |pages=21–7 |date=March 2015 |pmid=25621227 |pmc=4298582 |doi=10.1007/s12070-014-0736-0 |url=}}</ref> : | ||
* '''T1''': isointense or hypointense | * '''T1''': isointense or hypointense | ||
* '''T1 C+ (Gd)''': intense enhancement | * '''T1 C+ (Gd)''': intense enhancement | ||
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* fascicular sign: multiple small ring-like structures | * fascicular sign: multiple small ring-like structures | ||
[[File:Schwannoma MRI.gif|400px|MR image of left sided vestibular schwannoma. Yellow dotted line is border between intra- and extrameatal portion of the tumour. Size quantified as the largest diameter measurable in the extrameatal portion (red line), Kleijwegt MC, van der Mey AG, Wiggers-deBruine FT, Malessy MJ, van Osch MJ. Perfusion magnetic resonance imaging provides additional information as compared to anatomical imaging for decision-making in vestibular schwannoma. Eur J Radiol Open. 2016;3:127–133. Published 2016 Jun 15. doi:10.1016/j.ejro.2016.05.005,https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4919314/]] | |||
==References== | ==References== | ||
Latest revision as of 23:22, 29 October 2019
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Schwannoma MRI On the Web |
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American Roentgen Ray Society Images of Schwannoma MRI |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Maneesha Nandimandalam, M.B.B.S.[2]
Overview
Schwannomas appear on T1 as 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. Signs can also be useful in diagnosing such as 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, fascicular sign: multiple small ring-like structures.
MRI
Schwannomas have fairly predictable signal characteristics [1] [2][3][4] [5][6] :
- 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
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ Singh K, Singh MP, Thukral C, Rao K, Singh K, Singh A (March 2015). "Role of magnetic resonance imaging in evaluation of cerebellopontine angle schwannomas". Indian J Otolaryngol Head Neck Surg. 67 (1): 21–7. doi:10.1007/s12070-014-0736-0. PMC 4298582. PMID 25621227.