Magnetic Resonance Imaging Appearance of Schwannomas from Head to Toe: A Pictorial Review

Crist, Jamie; Hodge, Jacob R; Frick, Matthew A.; Leung, Fiona P.; Hsu, Eugene; Gi, Ming Tye; Venkatesh, Sudhakar K.

doi:10.4103/jcis.jcis_40_17

Cited by 62 publications

(64 citation statements)

References 10 publications

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“…[9][10][11][12][13] On MRI, schwannomas typically appear spindle shaped, oval, round, or even cystic, and they reveal a homogeneous contrast enhancement. 4,14,15 Similar image characteristics can be observed in neurofibroma and even malignant PNSTs. 9,15 For this reason, Karsy et al emphasized the need for additional imaging modalities to achieve a better preoperative diagnostic workup.…”

Section: Introductionmentioning

confidence: 54%

“…4,14,15 Similar image characteristics can be observed in neurofibroma and even malignant PNSTs. 9,15 For this reason, Karsy et al emphasized the need for additional imaging modalities to achieve a better preoperative diagnostic workup. 9 Meanwhile during the last decade, neurosonography has gained increasing importance, especially in the diagnosis of traumatic peripheral nerve lesions, 5,[16][17][18] but also concerning PNSTs, ongoing research has shown promising results.…”

Section: Introductionmentioning

confidence: 54%

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Quantitative Analysis of Superb Microvascular Imaging versus Color-Coded Doppler Sonography for Preoperative Evaluation of Vascularization of Schwannomas

Kloth

Eissler

Schmidberger

et al. 2019

J Neurol Surg A Cent Eur Neurosurg

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Purpose Comparison of vascularization of schwannomas, benign peripheral nerve sheath tumors, using color-coded Doppler sonography (CCDS) and the Toshiba monochrome Superb Microvascular Imaging (mSMI) (Minato, Tokyo, Japan) technique. Methods In a retrospective single-center analysis, 16 patients were identified with histologically confirmed schwannomas. Between March and June 2018, all of them underwent ultrasonography using mSMI and CCDS before surgery. Schwannoma vascularization was quantitatively measured using ImageJ, an open platform for scientific image analysis. As the diagnostic gold standard, magnetic resonance imaging was mandatory. Results The mSMI and CCDS vascularization showed a moderate agreement between the techniques (κ = 0.5556; p = 0.0066). The quantitative visual assessment of the vascularization revealed no difference (25.3 ± 8.2 vs. 18.2 ± 3.8; p = 0.0532). Significant differences were found for the quantitative assessment of CCDS with ImageJ (26.8 ± 8.8 vs. 19.3 ± 2.8; p = 0.0368). However, in a subanalysis of highly vascularized schwannomas, mSMI revealed significant differences to slightly vascularized schwannomas (32.0 ± 8.2 vs. 21.3 ± 6.1; p = 0.0065) but not between moderately and slightly vascularized types (p = not significant). Conclusion The mSMI mode is qualitatively superior to conventional CCDS; however, quantitative analysis of the vascularization of schwannomas revealed no significant quantitative advantage for mSMI. Nevertheless, the mean ImageJ values showed a positive trend toward a better representation of the vascularization degree of schwannomas with mSMI.

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Section: Introductionmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 54%

Quantitative Analysis of Superb Microvascular Imaging versus Color-Coded Doppler Sonography for Preoperative Evaluation of Vascularization of Schwannomas

Kloth

Eissler

Schmidberger

et al. 2019

J Neurol Surg A Cent Eur Neurosurg

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“…The T1-weighted images can visualize intratumoral hemorrhage as an isointense or hyperintense area [58,59]. On T2-weighted images VS shows hyperintense signals [55,60]. The cysts of VS are hyperintense and the tumor can appear heterogeneous when there is cystic degeneration [58,61].…”

Section: Imaging Of Vsmentioning

confidence: 99%

Therapy of Sporadic and NF2-Related Vestibular Schwannoma

Yao

Alahmari

Temel

et al. 2020

Cancers

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Vestibular schwannoma (VS) is a benign primary brain tumor that occurs sporadic or as part of a genetic syndrome. The most common cause is the mutation of the NF2 tumor suppressor gene that is involved in the production of the protein merlin. Merlin plays a role in cell growth and cell adhesion. In patients with NF2, the VSs arise bilaterally and coincide with other brain tumors. In sporadic VS, the tumor is typically unilateral and does not coincide in combination with other tumors. MRI is the standard imaging technique and can be used to assess the size and aspect of the tumor as well as the progression of disease. The preferred management of large VS in both VS types is surgery with or without adjuvant radiation. The management for the medium- or small-sized VS includes wait and scan, radiotherapy and/or surgery. This choice depends on the preference of the patient and institutional protocols. The outcomes of surgical and radiotherapy treatments are improving due to progress in surgical equipment/approaches, advances in radiation delivery techniques and dose optimizations protocols. The main purpose of the management of VS is preserving function as long as possible in combination with tumor control.

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“…On magnetic resonance imaging (MRI), classical signs like 'split-fat sign' and 'target sign' may be present. Degenerative changes like hyalinisation, haemorrhage, calci cation and cyst formation may occur [2]. Purely cystic schwannomas are rarely encountered.…”

Section: Introductionmentioning

confidence: 99%

A Rare Presentation of Schwannoma as a Purely-Cystic Superficial-Intermuscular Extra-Spinal Swelling over Upper Back.

Saha¹

2020

Preprint

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Schwannomas are rare tumours arising from peripheral nerve sheath. Here, a 44-year-old lady came to our clinic with an asymptomatic progressively-enlarging swelling over her upper back. It was fluctuant, with an absence of pain and tenderness. MRI showed a benign, purely-cystic, superficial-intermuscular, extra-spinal swelling nearby upper thoracic vertebrae. Complete surgical excision proceeded smoothly through a well-defined plane between the swelling and the muscles. It was not attached to any identifiable nerve. A 6.5x5.0x2.5 cm ovoid lesion with a glistening whitish-grey capsule was excised and wound reconstructed in layers. Histopathology showed hypercellular areas with nuclear palisading or oval-shaped Verocay bodies. Only S-100 tested positive amongst the five-antigen immunohistochemistry, thus establishing the diagnosis of a schwannoma. Postoperatively, a one-year follow-up period was uneventful. Schwannomas can surprise clinicians by arising anywhere and with atypical presentations. It needs to be in the differential diagnoses of any asymptomatic slowly-growing lesion.

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Magnetic Resonance Imaging Appearance of Schwannomas from Head to Toe: A Pictorial Review

Cited by 62 publications

References 10 publications

Quantitative Analysis of Superb Microvascular Imaging versus Color-Coded Doppler Sonography for Preoperative Evaluation of Vascularization of Schwannomas

Quantitative Analysis of Superb Microvascular Imaging versus Color-Coded Doppler Sonography for Preoperative Evaluation of Vascularization of Schwannomas

Therapy of Sporadic and NF2-Related Vestibular Schwannoma

A Rare Presentation of Schwannoma as a Purely-Cystic Superficial-Intermuscular Extra-Spinal Swelling over Upper Back.

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