MR imaging differentiation of benign and malignant peripheral nerve sheath tumors: use of the target sign

Bhargava, Ravi; Parham, David M.; Lasater, Olga E.; Chari, Radha; Chen, Gang; Fletcher, Barry D.

doi:10.1007/s002470050082

Cited by 222 publications

(137 citation statements)

References 15 publications

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“…The definition of the target sign has varied in past studies. [8][9][10][11] Koga et al 12 examined these previous articles, defined the characteristic target sign on MRI and clarified its sensitivity and specificity based on histology. In this study, we employed the definitions of a target sign developed by Koga et al: 12 (1) a biphasic pattern on T 2 weighted images (T 2 WIs) and gadolinium (Gd)-enhanced T 1 weighted images (T 1 WIs); (2) higher intensity peripherally and lower intensity centrally on T 2 WIs; and (3) higher intensity centrally by focal enhancement and lower intensity peripherally on Gdenhanced T 1 WIs.…”

Section: Methodsmentioning

confidence: 99%

Imaging findings of neurogenic tumours in the head and neck region

Kami¹,

Chikui²,

Okamura³

et al. 2012

Dentomaxillofacial Radiology

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Objective: The aim of this study was to describe the CT, MRI and ultrasonography findings of five cases of neurogenic tumours in the head and neck region. Methods: Five neurogenic tumours were analysed with respect to their CT value, the presence of cystic change, target sign, lobulation, connection to the nerve and vascularity. Results: The contrast-enhanced CT (ECT) of the schwannomas demonstrated either a mass with low enhancement (two out of three cases), which reflected the predominant Antoni B components, or a mass with cystic changes, which was an Antoni A-based schwannoma displaying cystic changes (one out of three cases). On MRI, all tumours showed homogeneous and isointense signals for muscle on T 1 weighted images (T 1 WIs). T 2 weighted images (T 2 WIs) and gadolinium (Gd)-enhanced T 1 WIs demonstrated target sign in both schwannomas. Ultrasound examination showed a well-defined, ovoid or round hypoechoic mass. The direct connection to the nerve was demonstrated in two of the five cases. Lobulation was observed in only one of the five cases and cystic changes were observed in one of the five cases. In all of the cases, no vascularity was seen in power Doppler images (PDIs) obtained percutaneously. Conclusions: Low-enhanced areas on ECTs can be specific for schwannomas, which suggests the predominance of Antoni B components. The target sign on T 2 WIs and Gdenhanced T 1 WIs can be specific, which can be used to differentiate the two different components (Antoni A and Antoni B). The direct connection to the nerve can be a specific finding for neurogenic tumours; however, at present the sensitivity is 40%.

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Section: Methodsmentioning

confidence: 99%

Imaging findings of neurogenic tumours in the head and neck region

Kami¹,

Chikui²,

Okamura³

et al. 2012

Dentomaxillofacial Radiology

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“…However, it has been shown that these criteria are not reliable indicators of malignancy and can be present in benign neuroˆbromas. 2,5,6 Recently, DWI has been used to detect and characterize tumors. DWI is a technique in which phase-defocusing and -refocusing gradients are used to evaluate the rate of microscopic water diŠu-sion within tissue.…”

Section: Discussionmentioning

confidence: 99%

Diffusion-weighted Imaging of Retroperitoneal Malignant Peripheral Nerve Sheath Tumor in a Patient with Neurofibromatosis Type 1

et al. 2008

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We present the diŠusion-weighted imaging (DWI)ˆndings for a malignant peripheral nerve sheath tumor arising in a retroperitoneal plexiform neuroˆbroma in a patient with neuroˆbromatosis type 1. Signal intensity of the malignant area was high on DWI and low on the apparent diŠusion coe‹cient map and diŠered fromˆndings for the benign area. DWI enabled clear diŠerentiation between malignant and benign areas of the tumor.

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“…On T2-weighted images, they are either of heterogeneous high signal intensity or display a target sign (68)(69)(70). The target sign is characterized by a hypo-to isointense center surrounded by a peripheral hyperintense ring, which corresponds histologically with a central zone of tightly packed fibers, consisting of collagen or a highly cellular component, and a peripheral zone of nonfibrillary stromal or myxoid material (68)(69)(70)(71). The target pattern is usually absent in large masses and in tumors with cystic, hemorrhagic, or necrotic degeneration (70).…”

Section: Schwannomamentioning

confidence: 99%

Pediatric Soft-Tissue Tumors and Pseudotumors: MR Imaging Features with Pathologic Correlation

Laffan¹,

Ngan²,

Navarro³

2009

RadioGraphics

117

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MR imaging differentiation of benign and malignant peripheral nerve sheath tumors: use of the target sign

Abstract: The target sign on T2-weighted MR imaging is helpful in differentiating neurofibromas from malignant peripheral nerve sheath tumors.

Cited by 222 publications

References 15 publications

Imaging findings of neurogenic tumours in the head and neck region

Imaging findings of neurogenic tumours in the head and neck region

Diffusion-weighted Imaging of Retroperitoneal Malignant Peripheral Nerve Sheath Tumor in a Patient with Neurofibromatosis Type 1

Pediatric Soft-Tissue Tumors and Pseudotumors: MR Imaging Features with Pathologic Correlation

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