Diffusion tensor imaging and tractography for preoperative assessment of benign peripheral nerve sheath tumors

Gersing, Alexandra S.; Cervantes, Barbara; Knebel, Carolin; Schwaiger, Benedikt J.; Kirschke, Jan S.; Weidlich, Dominik; Claudi, Carolin; Peeters, Johannes M.; Pfeiffer, Franz; Rummeny, Ernst J.; Karampinos, Dimitrios C.; Woertler, Klaus

doi:10.1016/j.ejrad.2020.109110

Cited by 8 publications

(5 citation statements)

References 41 publications

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“…Neurofibroma cells grow along the nerve fibers, infiltrate, and envelop the nerve fibers diffusely, and the tumor cannot be distinguished from the nerve fibers. 4 Fusiform enlargement of the parent nerve fascicle can be demonstrated on gross examination. 13 The pathological feature may explain the ultrasound findings of the angular margin in one or two sides in the longitudinal views, indicating the relationship between the tumor and the affected nerve.…”

Section: Discussionmentioning

confidence: 99%

“…This phenomenon may be explained by the growth pattern of neurofibroma. Neurofibroma cells grow along the nerve fibers, infiltrate, and envelop the nerve fibers diffusely, and the tumor cannot be distinguished from the nerve fibers 4 . Fusiform enlargement of the parent nerve fascicle can be demonstrated on gross examination 13 .…”

Section: Discussionmentioning

confidence: 99%

“…The “rat tail sign,” which is specific for neurogenic tumors, is easier to be found on imaging. Meanwhile, current imaging studies of neurofibromas are mainly focused on deep neurofibromas 3,4 . Localized cutaneous neurofibromas affect small nerves and manifest as nodular lesions.…”

Section: Introductionmentioning

confidence: 99%

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Investigations on ultrasonography in the diagnosis of nodular localized cutaneous neurofibroma

Shen,

Wang,

Zhao

et al. 2024

J of Clinical Ultrasound

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ObjectiveTo describe the ultrasound characteristics of nodular localized cutaneous neurofibroma (NLCN).Materials and MethodsClinical features and ultrasound characteristics of 43 lesions of 40 patients pathologically proven as NLCNs at Peking University Shenzhen Hospital from October 2014 to May 2022 were analyzed retrospectively. The location, length‐to‐thickness (L/T) ratio, thickness‐to‐width (T/W) ratio, shape, margin, capsule, echogenicity, echotexture, posterior features, vascularity, and “rat tail sign” were evaluated.ResultsAll ultrasound findings showed almost perfect agreement. More than a half of NLCNs (n = 24, 55.8%, p < 0.001) were located in the subcutaneous fat layer wholly with well‐demarcation from dermis and deep fascia. Most of the NLCNs were fusiform shape (n = 27, 62.8%, p < 0.001) in the long axis and oval shape (n = 35, 81.4%, p < 0.001) in the short axis. The other ultrasound findings of NLCNs included well‐defined (n = 42, 97.7%, p < 0.001), encapsulated (n = 39, 90.7%, p < 0.001), predominately hypoechoic (n = 34, 79.1%, p < 0.001), homogeneous (n = 39, 90.7%, p < 0.001), posterior enhancement (n = 29, 67.4%, p = 0.033), and avascularity (n = 37, 86.0%, p < 0.001). Only a quarter (n = 11, 25.6%, p = 0.002) of lesions were recognized with the “rat tail sign.”ConclusionNLCNs present as fusiform shape in long axis and round shape in short axis. The common ultrasound findings of NLCNs are well‐defined, encapsulated, predominately hypoechoic, homogeneous lesion with posterior enhancement, and poor blood supply. The “rat tail sign” has low sensitivity in NLCNs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Investigations on ultrasonography in the diagnosis of nodular localized cutaneous neurofibroma

Shen,

Wang,

Zhao

et al. 2024

J of Clinical Ultrasound

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“…RD and AD reflect the preferential direction of diffusion, perpendicular and parallel to fiber orientation, respectively, and are potentially more specific markers of demyelination and axonal damage, respectively [17] DTI has not been applied yet to the investigation of ATTRv and offers potential advantages compared to other MR techniques, as reference values for the different DTI parameters already exist for the main peripheral nerve trunks in normal subjects [18]. Another potential advantage is represented by DTI fiber tracking that is increasingly used for visual display of peripheral nerves course [19][20][21][22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance neurography and diffusion tensor imaging of the sciatic nerve in hereditary transthyretin amyloidosis polyneuropathy

Gasparotti,

Salvalaggio,

Corbo

et al. 2023

J Neurol

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The therapeutic advance in hereditary transthyretin amyloidosis (ATTRv amyloidosis) requires quantitative biomarkers of nerve involvement in order to foster early diagnosis and monitor therapy response. We aimed at quantitatively assessing Magnetic Resonance Neurography (MRN) and Diffusion Tensor Imaging (DTI) properties of the sciatic nerve in subjects with ATTRv-amyloidosis-polyneuropathy (ATTRv-PN) and pre-symptomatic carriers (ATTRv-C). Twenty subjects with pathogenic variants of the TTR gene (mean age 62.20 ± 12.04 years), 13 ATTRv-PN, and 7 ATTRv-C were evaluated and compared with 20 healthy subjects (mean age 60.1 ± 8.27 years). MRN and DTI sequences were performed at the right thigh from the gluteal region to the popliteal fossa. Cross-sectional-area (CSA), normalized signal intensity (NSI), and DTI metrics, including fractional anisotropy (FA), mean (MD), axial (AD), and radial diffusivity (RD) of the right sciatic nerve were measured. Increased CSA, NSI, RD, and reduced FA of sciatic nerve differentiated ATTRv-PN from ATTRv-C and healthy subjects at all levels (p < 0.01). NSI differentiated ATTRv-C from controls at all levels (p < 0.05), RD at proximal and mid-thigh (1.04 ± 0.1 vs 0.86 ± 0.11 p < 0.01), FA at mid-thigh (0.51 ± 0.02 vs 0.58 ± 0.04 p < 0.01). According to receiver operating characteristic (ROC) curve analysis, cutoff values differentiating ATTRv-C from controls (and therefore identifying subclinical sciatic involvement) were defined for FA, RD, and NSI. Significant correlations between MRI measures, clinical involvement and neurophysiology were found. In conclusion, the combination of quantitative MRN and DTI of the sciatic nerve can reliably differentiate ATTRv-PN, ATTRv-C, and healthy controls. More important, MRN and DTI were able to non-invasively identify early subclinical microstructural changes in pre-symptomatic carriers, thus representing a potential tool for early diagnosis and disease monitoring.

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“…Diffusion tensor imaging (DTI) is a noninvasive MR imaging modality that provides a quantitative insight into the neuronal architecture [10] and has been extensively used to image peripheral neuropathy [11][12][13][14]. Previous studies suggest that DTI may be the most sensitive noninvasive imaging method to detect microstructural alterations of peripheral nerves in DPN, and showed reduced fractional anisotropy (FA) of peripheral nerves in DPN patients compared with that of healthy controls (HCs) in the sciatic, tibial, and peroneal nerves [5,9,[15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Lumbosacral Nerve Roots in Patients with Type 2 Diabetic Peripheral Neuropathy Using Diffusion Tensor Imaging

Chen

Wang

et al. 2023

Brain Sciences

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Background: Diffusion tensor imaging (DTI) has found clinical applications in the evaluation of the central nervous system and has been extensively used to image peripheral neuropathy. However, few studies have focused on lumbosacral nerve root fiber damage in diabetic peripheral neuropathy (DPN). The aim of the study was to evaluate whether DTI of the lumbosacral nerve roots can be used to detect DPN. Methods: Thirty-two type 2 diabetic patients with DPN and thirty healthy controls (HCs) were investigated with a 3T MRI scanner. DTI with tractography of the L4, L5, and S1 nerve roots was performed. Anatomical fusion with the axial T2 sequences was used to provide correlating anatomical information. Mean fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were measured from tractography images and compared between groups. Diagnostic value was assessed using receiver operating characteristic (ROC) analysis. The Pearson correlation coefficient was used to explore the correlation between DTI parameters and clinical data and the nerve conduction study (NCS) in the DPN group. Results: In the DPN group, FA was decreased (p < 0.001) and ADC was increased (p < 0.001) compared with the values of the HC group. FA displayed the best diagnostic accuracy, with an area under the ROC curve of 0.716. ADC was positively correlated with HbA1c level (r = 0.379, p = 0.024) in the DPN group. Conclusions: DTI of lumbosacral nerve roots demonstrates appreciable diagnostic accuracy in patients with DPN.

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Diffusion tensor imaging and tractography for preoperative assessment of benign peripheral nerve sheath tumors

Cited by 8 publications

References 41 publications

Investigations on ultrasonography in the diagnosis of nodular localized cutaneous neurofibroma

Investigations on ultrasonography in the diagnosis of nodular localized cutaneous neurofibroma

Magnetic resonance neurography and diffusion tensor imaging of the sciatic nerve in hereditary transthyretin amyloidosis polyneuropathy

Assessment of Lumbosacral Nerve Roots in Patients with Type 2 Diabetic Peripheral Neuropathy Using Diffusion Tensor Imaging

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