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KMID : 0858520150190030153
Journal of the Korean Society of Magnetic Resonance in Medicine
2015 Volume.19 No. 3 p.153 ~ p.161
Useful MRI Features for Distinguishing Benign Peripheral Nerve Sheath Tumors and Myxoid Tumors in the Musculoskeletal System
Lee Eun-chae

Lee Guen-Young
Cho Whan-Sung
Lee Joon-Woo
Ahn Joong-Mo
Lee Eugene
Kang Heung-Sik
Abstract
Purpose: To identify the differential MRI findings between myxoid tumors and benign peripheral nerve sheath tumors (BPNSTs) in the musculoskeletal system.

Materials and Methods: The study participants included a total of 35 consecutive patients who underwent MRI between September 2011 and December 2013. The patients were pathologically diagnosed with myxoid tumors (22 patients) or BPNSTs (13 patients). Evaluation was done by two radiologists, based on the following characteristics: size, margin, degree of signal intensity (SI) on T2-weighted images (T2WI), homogeneity of SI on T2WI, enhancement pattern, enhancement homogeneity, presence of cystic portion, internal fat component, presence of fat split sign, presence of target sign, presence of continuation with adjacent neurovascular bundle, and presence of surrounding halo.

Results: Large size, high SI on T2WI, heterogeneous enhancement, and internal fat component were commonly observed in myxoid tumors, while homogenous enhancement, fat split sign, target sign were common in BPNSTs. The differences were statistically significant (P < 0.05). Other findings, such as margin, homogeneity of SI on T2WI, enhancement pattern (peripheral or solid), internal cystic portion, continuation with neurovascular bundle, and surrounding halo, did not show significant difference between myxoid tumors and BPNSTs (P > 0.05).

Conclusion: In the differential diagnosis of myxoid tumors and BPNSTs involving the musculoskeletal system, several MRI findings such as degree of SI on T2WI, enhancement homogeneity, internal fat component, fat split sign, and target sign, may be helpful in establishing the diagnosis.
KEYWORD
Soft tissue tumor, Benign peripheral nerve sheath tumor, Myxoid tumor, Magnetic resonance imaging (MRI)
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