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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
"Visualizing MSK Radiology: A Practical Guide to Radiology Mastery"
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#MedicalImaging, #Radiology, #Ultrasound, #MRI, #PNSTs, #NeurogenicTumors, #Schwannoma, #Neurofibroma,
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