Extraaxial neurofibromas versus neurilemmomas: Discrimination with MRI

Won Hee Jee, Soon Nam Oh, Thomas McCauley, Kyung Nam Ryu, Jin Suck Suh, Jeong Hoon Lee, Jung Mi Park, Kyung Ah Chun, Mi Sook Sung, Kijun Kim, Yeon Soo Lee, Yong Koo Kang, In Young Ok, Jung Man Kim

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Abstract

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.

Original languageEnglish
Pages (from-to)629-633
Number of pages5
JournalAmerican Journal of Roentgenology
Volume183
Issue number3
DOIs
Publication statusPublished - 2004 Sep

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

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    Jee, W. H., Oh, S. N., McCauley, T., Ryu, K. N., Suh, J. S., Lee, J. H., Park, J. M., Chun, K. A., Sung, M. S., Kim, K., Lee, Y. S., Kang, Y. K., Ok, I. Y., & Kim, J. M. (2004). Extraaxial neurofibromas versus neurilemmomas: Discrimination with MRI. American Journal of Roentgenology, 183(3), 629-633. https://doi.org/10.2214/ajr.183.3.1830629