Schwannoma MRI
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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.