Benign peripheral nerve sheath tumor of digit versus major-nerve: Comparison of MRI findings

Abstract

Objective To compare the symptoms and magnetic resonance imaging (MRI) findings between digital peripheral nerve sheath tumor (PNST) and major-nerve PNST. Methods A total 36 cases with benign PNSTs (16 digital, 20 major-nerve) were enrolled. Chief complaint and Tinel sign were reviewed. Five classic MRI features of PNST, the signal intensity (SI), the enhancement, and the shape of tumor were evaluated on MRI. Results Half of each group showed tenderness. Tinel sign was less frequent in digital PNST (12.5%) than major-nerve PNST (95.0%, P < 0.001). Split fat sign, entering and exiting nerve, target sign, and thin hyperintense rim were only observed in major-nerve PNST (P = <0.001, <0.001, 0.492, and 0.002, respectively). Fascicular sign was found in digital PNSTs (31.3%), but more frequent in major-nerve PNST (P < 0.001). In digital PNSTs, mild hyperintense SIs (56.2%) on T1-weighted images (T1-WI) was noted, but none in major-nerve PNST (P < 0.001). Both groups showed hyperintense SIs on T2-WI (P = 0.371). Homogeneity on T2-WI was noted in 43.8% of digital PNSTs, but none in major-nerve PNSTs (P = 0.004). Both groups showed heterogeneous enhancement (P = 0.066), but four (25%) digital PNSTs showed homogeneous enhancement. Lobulated shape was noted in 50% of digital PNSTs but none of major-nerve PNSTs (P = 0.001). Digital nerve was involved at 81.3% of digital PNSTs. Three foot cases showed unusual manifestations: bone destruction, skin thickening, and subungual location. Conclusion In digital PNSTs, Tinel sign is not commonly found and classic MRI findings is insufficient. In addition, some digital PNSTs show different SI and enhancement from major-nerve PNSTs.

Amide Proton Transfer-weighted MRI combined with serum prostate-specific antigen levels for differentiating malignant prostate lesions from benign prostate lesions: a retrospective cohort study

“…Early diagnosis of prostate cancer improves its prognosis [ 1 , 2 ], while screening tools should be further upgraded [ 10 , 11 , 14 , 15 ]. Therefore, the present study aimed to explore the value of the novel functional MRI technique, APT-weighted MRI, combined with serum PSA levels for differentiating malignant prostate lesions from benign prostate lesions.…”

“…Serum prostate-specific antigen (PSA) is the biochemical biomarker that has been highly acknowledged in clinical practice for prostate diseases [ 13 ]. Nevertheless, this biomarker is not perfect [ 14 , 15 ], and its combination with other biomarkers could result in better sensitivity and specificity for prostate cancer.…”

Diagnostic accuracy of multiparametric ultrasound for peripheral nerve schwannoma

“…Classic MRI findings of schwannomas include the split-fat sign, target sign, fascicular pattern, entering and exiting nerve, and a thin hyperintense rim (18). However, when MRI assessment is not possible or advisable, US equipment might be used partially instead of MRI (19,20).…”

Synovial Sarcoma in the Extremity: Diversity of Imaging Features for Diagnosis and Prognosis

“…In particular, synovial sarcoma tends to display inhomogeneous enhancement, whereas ganglion cysts typically remain unenhanced [60]. Masses originating from peripheral nerves and nerve sheaths are frequently encountered, with the majority being attributed to benign peripheral nerve sheath tumors (BPNST) like schwannomas (neurilemmomas) and neurofibromas [61,62]. However, peripheral non-neural sheath tumors are rare, except for the more prevalent ganglion cysts of the peripheral nerves [63].…”