Benign peripheral nerve sheath tumor of digit versus major-nerve: Comparison of MRI findings.

oleh: Seul Ki Lee, Jee-Young Kim, Hyang Sook Jeong

Format: Article
Diterbitkan: Public Library of Science (PLoS) 2020-01-01

Deskripsi

<h4>Objective</h4>To compare the symptoms and magnetic resonance imaging (MRI) findings between digital peripheral nerve sheath tumor (PNST) and major-nerve PNST.<h4>Methods</h4>A total 36 cases with benign PNSTs (16 digital, 20 major-nerve) were enrolled. Chief complaint and Tinel sign were reviewed. Five classic MRI features of PNST, the signal intensity (SI), the enhancement, and the shape of tumor were evaluated on MRI.<h4>Results</h4>Half of each group showed tenderness. Tinel sign was less frequent in digital PNST (12.5%) than major-nerve PNST (95.0%, P < 0.001). Split fat sign, entering and exiting nerve, target sign, and thin hyperintense rim were only observed in major-nerve PNST (P = <0.001, <0.001, 0.492, and 0.002, respectively). Fascicular sign was found in digital PNSTs (31.3%), but more frequent in major-nerve PNST (P < 0.001). In digital PNSTs, mild hyperintense SIs (56.2%) on T1-weighted images (T1-WI) was noted, but none in major-nerve PNST (P < 0.001). Both groups showed hyperintense SIs on T2-WI (P = 0.371). Homogeneity on T2-WI was noted in 43.8% of digital PNSTs, but none in major-nerve PNSTs (P = 0.004). Both groups showed heterogeneous enhancement (P = 0.066), but four (25%) digital PNSTs showed homogeneous enhancement. Lobulated shape was noted in 50% of digital PNSTs but none of major-nerve PNSTs (P = 0.001). Digital nerve was involved at 81.3% of digital PNSTs. Three foot cases showed unusual manifestations: bone destruction, skin thickening, and subungual location.<h4>Conclusion</h4>In digital PNSTs, Tinel sign is not commonly found and classic MRI findings is insufficient. In addition, some digital PNSTs show different SI and enhancement from major-nerve PNSTs. However, digital soft tissue tumor involving digital neurovascular bundle and especially representing a fascicular sign should be considered the possibility of a digital PNST.