Advanced MR Imaging of Peripheral Nerve Sheath Tumors Including Diffusion Imaging

Abstract

Peripheral nerve sheath tumors (PNSTs) are neoplasms derived from neoplastic Schwann cells or their precursors. Whereas benign PNSTs are relatively common and considered curable lesions, their malignant counterparts are rare but highly aggressive and require early diagnosis and treatment. MR imaging has been the modality of choice for noninvasive evaluation of PNSTs. This article discusses the features of PNSTs in conventional and advanced MR imaging, and it emphasizes the features that help differentiate benign and malignant variants.

Keywords

peripheral nerve sheath tumor - magnetic resonance imaging - magnetic resonance neurography - diffusion-weighted imaging - diffusion tensor imaging

• References

• 1 Ligon KL, Mokctari K, Smith TW. Tumors of the central nervous sysyem. In: Gray F, Duyckaerts C, De Girolami U, , eds. Escourolle & Poirier's Manual of Basic Neuropathology. New York, NY: Oxford University Press; 2014: 20-58
• 2 Bhargava R, Parham DM, Lasater OE, Chari RS, Chen G, Fletcher BD. MR imaging differentiation of benign and malignant peripheral nerve sheath tumors: use of the target sign. Pediatr Radiol 1997; 27 (2) 124-129
• 3 Banks KP. The target sign: extremity. Radiology 2005; 234 (3) 899-900
• 4 Chhabra A, Soldatos T, Durand DJ, Carrino JA, McCarthy EF, Belzberg AJ. The role of magnetic resonance imaging in the diagnostic evaluation of malignant peripheral nerve sheath tumors. Indian J Cancer 2011; 48 (3) 328-334
• 5 Le LQ, Liu C, Shipman T, Chen Z, Suter U, Parada LF. Susceptible stages in Schwann cells for NF1-associated plexiform neurofibroma development. Cancer Res 2011; 71 (13) 4686-4695
• 6 Ahlawat S, Chhabra A, Blakely J. Magnetic resonance neurography of peripheral nerve tumors and tumorlike conditions. Neuroimaging Clin N Am 2014; 24 (1) 171-192
• 7 Kransdorf M, Murphey MD. Neurogenic tumors. Imaging of Soft Tissue Tumors. Philadelphia, PA: Saunders; 1997: 235-273
• 8 Murphey MD, Smith WS, Smith SE, Kransdorf MJ, Temple HT. From the archives of the AFIP. Imaging of musculoskeletal neurogenic tumors: radiologic-pathologic correlation. Radiographics 1999; 19 (5) 1253-1280
• 9 Mautner VF, Hartmann M, Kluwe L, Friedrich RE, Fünsterer C. MRI growth patterns of plexiform neurofibromas in patients with neurofibromatosis type 1. Neuroradiology 2006; 48 (3) 160-165
• 10 Woertler K. Tumors and tumor-like lesions of peripheral nerves. Semin Musculoskelet Radiol 2010; 14 (5) 547-558
• 11 Kubiena H, Entner T, Schmidt M, Frey M. Peripheral neural sheath tumors (PNST)—what a radiologist should know. Eur J Radiol 2013; 82 (1) 51-55
• 12 Abreu E, Aubert S, Wavreille G, Gheno R, Canella C, Cotten A. Peripheral tumor and tumor-like neurogenic lesions. Eur J Radiol 2013; 82 (1) 38-50
• 13 Tsai WC, Chiou HJ, Chou YH, Wang HK, Chiou SY, Chang CY. Differentiation between schwannomas and neurofibromas in the extremities and superficial body: the role of high-resolution and color Doppler ultrasonography. J Ultrasound Med 2008; 27 (2) 161-166 ; quiz 168–169
• 14 Warbey VS, Ferner RE, Dunn JT, Calonje E, O'Doherty MJ. [18F]FDG PET/CT in the diagnosis of malignant peripheral nerve sheath tumours in neurofibromatosis type-1. Eur J Nucl Med Mol Imaging 2009; 36 (5) 751-757
• 15 Manaster BJ, May DA, Disler DG. Neural and synovial tumors. Musculoskeletal Imaging: The Requisites. 4th ed. Philadelphia, PA: Elsevier/Saunders; 2013: 432-442
• 16 Li CS, Huang GS, Wu HD , et al. Differentiation of soft tissue benign and malignant peripheral nerve sheath tumors with magnetic resonance imaging. Clin Imaging 2008; 32 (2) 121-127
• 17 Chee DW, Peh WC, Shek TW. Pictorial essay: imaging of peripheral nerve sheath tumours. Can Assoc Radiol J 2011; 62 (3) 176-182
• 18 Demehri S, Belzberg A, Blakeley J, Fayad LM. Conventional and functional MR imaging of peripheral nerve sheath tumors: initial experience. AJNR Am J Neuroradiol 2014; 35 (8) 1615-1620
• 19 Chhabra A, Thakkar RS, Andreisek G , et al. Anatomic MR imaging and functional diffusion tensor imaging of peripheral nerve tumors and tumorlike conditions. AJNR Am J Neuroradiol 2013; 34 (4) 802-807
• 20 Varma DG, Moulopoulos A, Sara AS , et al. MR imaging of extracranial nerve sheath tumors. J Comput Assist Tomogr 1992; 16 (3) 448-453
• 21 Mentzel T, Dei Tos AP, Fletcher CD. Perineurioma (storiform perineurial fibroma): clinico-pathological analysis of four cases. Histopathology 1994; 25 (3) 261-267
• 22 Macarenco RS, Ellinger F, Oliveira AM. Perineurioma: a distinctive and underrecognized peripheral nerve sheath neoplasm. Arch Pathol Lab Med 2007; 131 (4) 625-636
• 23 Wadhwa V, Thakkar RS, Maragakis N , et al. Sciatic nerve tumor and tumor-like lesions--uncommon pathologies. Skeletal Radiol 2012; 41 (7) 763-774
• 24 Lacour-Petit MC, Lozeron P, Ducreux D. MRI of peripheral nerve lesions of the lower limbs. Neuroradiology 2003; 45 (3) 166-170
• 25 Ducatman BS, Scheithauer BW, Piepgras DG, Reiman HM, Ilstrup DM. Malignant peripheral nerve sheath tumors. A clinicopathologic study of 120 cases. Cancer 1986; 57 (10) 2006-2021
• 26 Laurent F, Parrens M. Mediastinal masses. In: Gourtsoyiannis NC, Ros PR, , eds. Radiologic-Pathologic Correlations from Head to Toe: Understanding the Manifestations of Disease. Heidelberg, Germany: Springer; 2005: 185-226
• 27 Pilavaki M, Chourmouzi D, Kiziridou A, Skordalaki A, Zarampoukas T, Drevelengas A. Imaging of peripheral nerve sheath tumors with pathologic correlation: pictorial review. Eur J Radiol 2004; 52 (3) 229-239
• 28 Friedrich RE, Kluwe L, Fünsterer C, Mautner VF. Malignant peripheral nerve sheath tumors (MPNST) in neurofibromatosis type 1 (NF1): diagnostic findings on magnetic resonance images and mutation analysis of the NF1 gene. Anticancer Res 2005; 25 (3A): 1699-1702
• 29 Derlin T, Tornquist K, Münster S , et al. Comparative effectiveness of 18F-FDG PET/CT versus whole-body MRI for detection of malignant peripheral nerve sheath tumors in neurofibromatosis type 1. Clin Nucl Med 2013; 38 (1) e19-e25
• 30 Fayad LM, Wang X, Blakeley JO , et al. Characterization of peripheral nerve sheath tumors with 3T proton MR spectroscopy. AJNR Am J Neuroradiol 2014; 35 (5) 1035-1041
• 31 Thawait SK, Chaudhry V, Thawait GK , et al. High-resolution MR neurography of diffuse peripheral nerve lesions. AJNR Am J Neuroradiol 2011; 32 (8) 1365-1372
• 32 Chhabra A. MR neurography. Neuroimaging Clin N Am 2014; 24 (1) xvii
• 33 Chhabra A, Thawait GK, Andreisek G. Peripheral nerve tumor and tumor-like conditions. In: Chhabra A, Andreisek G, , eds. Magnetic Resonance Neurography. New Delhi, India: Jaypee Brothers Medical Publishers; 2012: 112-133