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Extraaxial Neurofibromas Versus Neurilemmomas: Discrimination with MRI

 Won-Hee Jee  ;  Soon-Nam Oh  ;  Jung-Man Kim  ;  In-Young Ok  ;  Yong-Koo Kang  ;  Yeon-Soo Lee  ;  Kijun Kim  ;  Mi-Sook Sung  ;  Kyung-Ah Chun  ;  Jung-Mi Park  ;  Jeong-Hoon Lee  ;  Jin-Suck Suh  ;  Kyung-Nam Ryu  ;  Thomas McCauley 
 AMERICAN JOURNAL OF ROENTGENOLOGY, Vol.183(3) : 629-633, 2004 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Child ; Diagnosis, Differential ; Female ; Humans ; Magnetic Resonance Imaging* ; Male ; Middle Aged ; Neurilemmoma/diagnosis* ; Neurofibroma/diagnosis* ; Retrospective Studies
OBJECTIVE: The purpose of our study was to evaluate whether MRI can discriminate between extraaxial neurofibromas and neurilemmomas. MATERIALS AND METHODS: MR images of 52 patients with a pathologically proven extraaxial neurofibroma or neurilemmoma were retrospectively reviewed by observers who were unaware of the surgical results, regarding the presence or absence of individual imaging criteria. MRI findings in 12 patients with a localized neurofibroma and 40 patients with a neurilemmoma were compared using the chi-square test or Fisher's exact test. RESULTS: MRI findings suggestive of neurofibroma (p < 0.05) were a target sign on T2-weighted images (58% in neurofibromas vs 15% in neurilemmomas), central enhancement (75% vs 8%), and a combination of both findings (63% vs 3%). MRI findings suggestive of a neurilemmoma (p < 0.05) were a fascicular appearance on T2-weighted images (25% vs 63%), a thin hyperintense rim on T2-weighted images (8% vs 58%), a combination of both findings (8% vs 48%), and diffuse enhancement (13% vs 67%). No significant difference was seen between neurofibromas and neurilemmomas for a centrally entering and exiting nerve (42% in neurofibromas vs 23% in neurilemmomas), a peripherally entering and exiting nerve (58% vs 77%), a cystic area (38% vs 64%), a low-signal margin (100% vs 100%), peripheral enhancement (13% vs 26%), or a target sign on contrast-enhanced images (11% vs 31%). CONCLUSION: MRI shows features helpful for differentiating extraaxial neurofibromas from neurilemmomas; however, no single finding or combination of findings allows definitive differentiation.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Suh, Jin Suck(서진석) ORCID logo https://orcid.org/0000-0001-9455-9240
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