Useful MRI Features for Distinguishing Benign Peripheral Nerve Sheath Tumors and Myxoid Tumors in the Musculoskeletal System
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Purpose: To identify the differential MRI findings between myxoid tumors and benignperipheral nerve sheath tumors (BPNSTs) in the musculoskeletal system. Materials and Methods: The study participants included a total of 35 consecutivepatients who underwent MRI between September 2011 and December 2013. The patients were pathologically diagnosed with myxoid tumors (22 patients)or BPNSTs (13 patients). Evaluation was done by two radiologists, based on thefollowing characteristics: size, margin, degree of signal intensity (SI) on T2-weightedimages (T2WI), homogeneity of SI on T2WI, enhancement pattern, enhancementhomogeneity, presence of cystic portion, internal fat component, presence of fat splitsign, presence of target sign, presence of continuation with adjacent neurovascularbundle, and presence of surrounding halo. Results: Large size, high SI on T2WI, heterogeneous enhancement, and internalfat component were commonly observed in myxoid tumors, while homogenousenhancement, fat split sign, target sign were common in BPNSTs. The differenceswere statistically significant (P < 0.05). Other findings, such as margin, homogeneityof SI on T2WI, enhancement pattern (peripheral or solid), internal cystic portion,continuation with neurovascular bundle, and surrounding halo, did not showsignificant difference between myxoid tumors and BPNSTs (P > 0.05). Conclusion: In the differential diagnosis of myxoid tumors and BPNSTs involvingthe musculoskeletal system, several MRI findings such as degree of SI on T2WI,enhancement homogeneity, internal fat component, fat split sign, and target sign,may be helpful in establishing the diagnosis.
Abstract
Purpose: To identify the differential MRI findings between myxoid tumors and benignperipheral nerve sheath tumors (BPNSTs) in the musculoskeletal system. Materials and Methods: The study participants included a total of 35 consecutivepatients who underwent MRI between September 2011 and December 2013. The patients were pathologically diagnosed with myxoid tumors (22 patients)or BPNSTs (13 patients). Evaluation was done by two radiologists, based on thefollowing characteristics: size, margin, degree of signal intensity (SI) on T2-weightedimages (T2WI), homogeneity of SI on T2WI, enhancement pattern, enhancementhomogeneity, presence of cystic portion, internal fat component, presence of fat splitsign, presence of target sign, presence of continuation with adjacent neurovascularbundle, and presence of surrounding halo. Results: Large size, high SI on T2WI, heterogeneous enhancement, and internalfat component were commonly observed in myxoid tumors, while homogenousenhancement, fat split sign, target sign were common in BPNSTs. The differenceswere statistically significant (P < 0.05). Other findings, such as margin, homogeneityof SI on T2WI, enhancement pattern (peripheral or solid), internal cystic portion,continuation with neurovascular bundle, and surrounding halo, did not showsignificant difference between myxoid tumors and BPNSTs (P > 0.05). Conclusion: In the differential diagnosis of myxoid tumors and BPNSTs involvingthe musculoskeletal system, several MRI findings such as degree of SI on T2WI,enhancement homogeneity, internal fat component, fat split sign, and target sign,may be helpful in establishing the diagnosis.
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