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✅ Knee MRI Mastery/Chap 4BCD. Anterior knee

(Fig 4-D.19) Tibial Nerve Schwannoma

by MSK MRI 2024. 6. 26.

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  • Certain solid tumors, especially myxomatous lesions, nerve sheath tumors, necrotic sarcomas, and vascular lesions may mimic cystic structures

 

📌  Key Imaging Features Indicating Neurogenic Origin

✅ Location in Major Nerve Region:

  • Masses found along the typical distribution of major nerves (e.g., median or sciatic nerve) suggest a neurogenic origin.

 

✅ Entering and Exiting Nerve:

  • Detection of tubular nerves entering and exiting the mass is a significant indicator of neurogenic neoplasms. 

 

✅ Fusiform Shape:

  • Lesions with a fusiform shape, indicating growth along the nerve's course, are characteristic of neurogenic neoplasms and rare in soft tissue sarcomas.

 

✅ Split-Fat Sign:

  • A rim of fat around the mass (split-fat sign) suggests the tumor's origin in the intermuscular space near the neurovascular bundle. 
  • This is commonly seen in benign PNSTs and best visualized on T1-weighted MR images.

 

✅ Muscle Abnormalities:

  • Atrophy with increased fat content or decreased muscle size supplied by the affected nerve can indicate PNSTs. 
  • This is subtle and best compared with the normal contralateral side using T1-weighted MR images. 
  • Edematous muscle appearance due to denervation may be seen on T2-weighted MR images.

 

References

  • Eur J Radiol. 2013 Jan;82(1):38-50
  • MRI Web Clinic – July 2020 Knee Bursae

 

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#MedicalImaging, #Radiology, #Ultrasound, #MRI, #PNSTs, #NeurogenicTumors, #Schwannoma, #Neurofibroma,