Diffusion-weighted imaging in extracranial head and neck schwannomas: A distinctive appearance

Das, Abanti; Bhalla, Ashu Seith; Sharma, Raju; Kumar, Atin; Thakar, Alok; Goyal, Ankur

doi:10.4103/0971-3026.184418

Cited by 18 publications

(5 citation statements)

References 17 publications

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“…This study suggested that the ADC quantitative assessment could not provide significant value for the differential diagnosis of both of the tumours. We found that the mean ADC values of these tumours were greater than the mean ADC values of neck paragangliomas and schwannomas [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

MR imaging features of benign retroperitoneal paragangliomas and schwannomas

et al. 2018

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BackgroundTo determine whether MRI feature analysis can differentiate benign retroperitoneal extra-adrenal paragangliomas and schwannomas.MethodsThe MRI features of 50 patients with confirmed benign retroperitoneal extra-adrenal paragangliomas and schwannomas were retrospectively reviewed by two radiologists blinded to the histopathologic diagnosis. These features were compared between two types of tumours by use of the Mann-Whitney test and binary logistic regression. The patients’ clinical characteristics were reviewed.ResultsAnalysis of MRI images from 50 patients revealed no significant differences in the quantitative MRI features of lesion size, ratio of diameter and apparent diffusion coefficient. There were significant differences in the qualitative MRI features of location, necrosis, cysts and degree of tumour enhancement for two readers, with no significant differences in the other qualitative MRI features between these tumours. The combination of necrosis with degree of tumour enhancement during the arterial phase increased the probability that a retroperitoneal mass would represent retroperitoneal extra-adrenal paraganglioma as opposed to schwannoma.ConclusionWe have presented the largest series of MRI features of both benign retroperitoneal extra-adrenal paragangliomas and schwannomas. Some MRI features assist in the differentiation between these tumours, with imaging features consisting of necrosis and avid enhancement during the arterial phase, suggestive of retroperitoneal extra-adrenal paragangliomas.

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Section: Discussionmentioning

confidence: 99%

MR imaging features of benign retroperitoneal paragangliomas and schwannomas

et al. 2018

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“…Furthermore, we observed that 13 cases had obviously higher signal intensity than that of the spleen in T2WI. The DWI of 13 cases represents the first report of cases in which the high signal intensity is much higher than that of the spleen, and the mean ADC values of all tumors were greater than those of neck paragangliomas 16 , 17 . DWI assessment may, therefore, be of significant value for differential diagnosis.…”

Section: Discussionmentioning

confidence: 93%

MR imaging features of benign retroperitoneal extra-adrenal paragangliomas

Shen

Zhong

Wang

et al. 2017

Sci Rep

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The goal of this study was to retrospectively review the magnetic resonance imaging (MRI) features of retroperitoneal extra-adrenal paragangliomas and to evaluate the diagnostic capabilities of MRI. Twenty-four patients with confirmed benign retroperitoneal extra-adrenal paragangliomas who underwent preoperative MRI and surgical resection were enrolled. The patients’ clinical characteristics and MRI features were reviewed by two radiologists. There were no significant differences in the qualitative and quantitative MRI features were determined by the reviewers. High signal intensity in T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) was observed in all tumors. In contrast T1-weighted imaging (T1WI) in the arterial phase, 83.33% of the tumors were clearly enhanced. In 87.5% of cases, a persistent enhancement pattern was observed in the venous and delayed phases, and 12.5% of tumors showed a “washout” pattern. The tumor capsule, intratumoral septum and degenerations were visualized in the tumors and may be helpful in the qualitative diagnosis of extra-adrenal paragangliomas in MRI. MRI was useful in locating the position, determining the tumor ranges and visualizing the relationship between the tumors and adjacent structures. The presence of typical clinical symptoms and positivity of biochemical tests are also important factors in making an accurate preoperative diagnosis.

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“… 5 The heterogeneous appearance of schwannomas may be attributed to degeneration and the plethora of cellular components such as cystic and xanthomatous lesions. 7 Small schwannomas tend to have homogenous contrast enhancement after gadolinium administration, whereas larger lesions have more heterogeneous enhancement. 5 FDG uptake by schwannomas is variable, so it is difficult to differentiate between benign and malignant tumours.…”

Section: Discussionmentioning

confidence: 99%

Laryngeal schwannoma with extralaryngeal extension mimicking a thyroid tumour

et al. 2021

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Objective: A schwannoma is a common benign tumour that can arise anywhere in the body. When it occurs in an unusual location such as the larynx, its differentiation from other tumours can be challenging. Herein, we report a case of a laryngeal schwannoma with extralaryngeal extension that mimicked a thyroid tumour, focusing on its characteristic features on MRI. Methods: A 19-year-old male presented with a mass in the left side of the neck and hoarseness for 2 years. Endoscopy showed a submucosal mass in the laryngeal region. MRI found a well-defined solid mass in the thyroid gland, extending to the larynx through the lower edge of the thyroid cartilage. T2 weighted MRI showed slightly low signal intensity at the central part of the tumour and high signal intensity at the peripheral part of the tumour. Pre-operative imaging suggested that the tumour originated in the thyroid gland. Left thyroidectomy with tumour excision was performed; the tumour was diagnosed as a laryngeal schwannoma with extralaryngeal extension, compressing the thyroid gland. In retrospect, features such as the dumbbell-shape and known as ‘target sign’ on T2 weighted MRI were typical features of schwannoma. Additionally, the tumour’s extension pattern was similar to previous reports of laryngeal schwannomas with extralaryngeal extension. Conclusion: A large laryngeal schwannoma may extend outside the larynx with significant compression of the thyroid gland. Understanding the pattern of extension and familiarity with the features on MRI can improve the preoperative diagnosis accuracy.

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Diffusion-weighted imaging in extracranial head and neck schwannomas: A distinctive appearance

Cited by 18 publications

References 17 publications

MR imaging features of benign retroperitoneal paragangliomas and schwannomas

MR imaging features of benign retroperitoneal paragangliomas and schwannomas

MR imaging features of benign retroperitoneal extra-adrenal paragangliomas

Laryngeal schwannoma with extralaryngeal extension mimicking a thyroid tumour

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