Skip to main content
SpringerLink
Log in

MR imaging differentiation of benign and malignant peripheral nerve sheath tumors: use of the target sign

  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Background

T2-weighted MR imaging of soft tissue tumors of neural origin may show round lesions with a central hypointensity and a hyperintense rim resembling a target. We define the “target sign” as a mass consisting of a solitary target, or a multicompartmental mass in which the largest component consists of multiple targets.

Objective

The objective of this study was to determine whether the target sign can differentiate benign neurofibromas and their malignant counterparts, malignant peripheral nerve sheath tumors.

Materials and methods

Preoperative T2-weighted MR images of 23 neurofibromas or malignant peripheral nerve sheath tumors were retrospectively reviewed in 16 patients, aged 3 weeks to 20 years (median 15 years), without knowledge of the pathologic diagnosis. The presence or absence of a target sign was noted.

Results

The target sign was seen in all 12 neurofibromas and 1 of the 11 malignant peripheral nerve sheath tumors. Statistical analysis showed good differentiation of benign and malignant tumors using this sign (x = 0.91).

Conclusion

The target sign on T2-weighted MR imaging is helpful in differentiating neurofibromas from malignant peripheral nerve sheath tumors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Elster AD (1992) Radiologic screening in the neurocutaneous syndromes: strategies and controversies (comment). AJNR 13: 1078–1082

    PubMed  CAS  Google Scholar 

  2. Shearer P, Parham D, Kovnar E, Kun L, Rao B, Lobe T, Pratt C (1994) Neurofibromatosis type I and malignancy: review of 32 pediatric cases treated at a single institution. Med Pediatr Oncol 22: 78–83

    Article  PubMed  CAS  Google Scholar 

  3. Holder TM, Snyder CL (1993) Miscellaneous tumors. In: Ashcraft KW, Holder TM (eds) Pediatric surgery. Saunders, Philadelphia, p 898

    Google Scholar 

  4. Harkin JC, Reed RJ (1969) Tumors of the peripheral nervous system. Armed Forces Institute of Pathology, Washington, DC

    Google Scholar 

  5. Moore SG, Bisset GS, Siegel MJ, Donaldson JS (1991) Pediatric musculoskeletal MR imaging. Radiology 179: 345–360

    PubMed  CAS  Google Scholar 

  6. Guz BV, Wood DP Jr., Montie JE, Pontes JE (1989) Retroperitoneal neural sheath tumors: Cleveland Clinic experience. J Urol 142: 1434–1437

    PubMed  CAS  Google Scholar 

  7. Glasier CM, Williamson MR, Lange TA (1989) MRI of peripheral neurofibromas in children. Orthopedics 12: 269–272

    PubMed  CAS  Google Scholar 

  8. Suh JS, Abenoza P, Galloway HR, Everson LI, Griffiths HJ (1992) Peripheral (extracranial) nerve tumors: correlation of MR imaging and histologic findings. Radiology 183: 341–346

    PubMed  CAS  Google Scholar 

  9. Li MH, Holtas S (1991) MR imaging of spinal neurofibromatosis. Acta Radiol 32: 279–285

    Article  PubMed  CAS  Google Scholar 

  10. Breidahl WH, Khangure MS (1991) MRI of lumbar and sacral plexus nerve sheath tumours. Australas Radiol 35: 140–144

    Article  PubMed  CAS  Google Scholar 

  11. Burk DL Jr, Brunberg JA, Kanal E, Latchaw RE, Wolf GL (1987) Spinal and paraspinal neurofibromatosis: surface coil MR imaging at 1.5 T. Radiology 162: 797–801

    PubMed  Google Scholar 

  12. Verstraete KL, Achten E, De Schepper A, Ramon F, Parizel P, Degryse H, Dierick AM (1992) Nerve sheath tumors: evaluation with CT and MR imaging. J Belge Radiol 75: 311–320

    PubMed  CAS  Google Scholar 

  13. Stull MA, Moser RP Jr, Kransdorf MJ, Bogumill GP, Nelson MC (1991) Magnetic resonance appearance of peripheral nerve sheath tumors. Skeletal Radiol 20: 9–14

    Article  PubMed  CAS  Google Scholar 

  14. Varma DG, Moulopoulos A, Sara AS, Leeds N, Kumar R, Kim EE, Wallace S (1992) MR imaging of extracranial nerve sheath tumors. J Comput Assist Tomogr 16: 448–453

    Article  PubMed  CAS  Google Scholar 

  15. Shonnard KM, Jelinek JS, Benedikt RA, Kransdorf MJ (1992) CT and MR of neurofibromatosis of the bladder. J Comput Assist Tomogr 16: 433–438

    Article  PubMed  CAS  Google Scholar 

  16. Hughes PM, Hawnaur JM, Jenkins JP, Isherwood I (1990) Craniospinal magnetic resonance imaging in neurofibromatosis (Abstract). Br J Radiol 63: 2

    Google Scholar 

  17. Anonymous (1988) Neurofibromatosis. Conference statement. National Institutes of Health Consensus Development Conference. Arch Neurol 45: 575–578

    Google Scholar 

  18. Enzinger FM, Weiss SW (1995) Soft tissue tumors, 3rd edn. Mosby, St Louis

    Google Scholar 

  19. Fleiss JL (1981) Statistical methods for rates and proportions. Wiley, New York, pp 217–225

    Google Scholar 

  20. Woodruff JM (1993) The pathology and treatment of peripheral nerve tumors and tumor-like conditions. CA Cancer J Clin 43: 290–308

    Article  PubMed  CAS  Google Scholar 

  21. Kransdorf MJ (1995) Benign soft-tissue tumors in a large referral population: distribution of specific diagnoses by age, sex, and location. AJR 164: 395–402

    PubMed  CAS  Google Scholar 

  22. Smirniotopoulos JG, Murphy FM (1992) The phakomatoses. AJNR 13: 725–746

    PubMed  CAS  Google Scholar 

  23. Lott IT, Richardson EP Jr (1981) Neuropathological findings and the biology of neurofibromatosis. Adv Neurol 29: 23–32

    PubMed  CAS  Google Scholar 

  24. Bass JC, Korobkin M, Francis IR, Ellis JH, Cohan RH (1994) Retroperitoneal plexiform neurofibromas: CT findings. AJR 163: 617–620

    PubMed  CAS  Google Scholar 

Download references

Author information

Author notes

  1. Ravi Bhargava

    Present address: Department of Radiology, University of Alberta Hospitals, Edmonton, Canada

  2. Radha S. Chari

    Present address: Department of Obstetrics and Gynecology, University of Alberta Hospitals, Edmonton, Canada

Authors and Affiliations

  1. Department of Diagnostic Imaging, St. Jude Children’s Research Hospital, 332 N. Lauderdale St., 38101, Memphis, TN, USA

    Ravi Bhargava & Barry D. Fletcher

  2. Department of Pathology and Laboratory Medicine, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA

    David M. Parham

  3. Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA

    Gang Chen

  4. Department of Radiology, University of Tennessee, Memphis, Tennessee, USA

    Ravi Bhargava & Barry D. Fletcher

  5. Department of Pathology, University of Tennessee, Memphis, Tennessee, USA

    David M. Parham

  6. Department of Obstetrics and Gynecology, University of Tennessee, Memphis, Tennessee, USA

    Radha S. Chari

  7. Department of Pediatrics, University of Tennessee, Memphis, Tennessee, USA

    Barry D. Fletcher

  8. Department of Pathology, Le Bonheur Children’s Medical Center, Memphis, Tennessee, USA

    Olga E. Lasater

Authors
  1. Ravi Bhargava
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David M. Parham
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Olga E. Lasater
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Radha S. Chari
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gang Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Barry D. Fletcher
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bhargava, R., Parham, D.M., Lasater, O.E. et al. MR imaging differentiation of benign and malignant peripheral nerve sheath tumors: use of the target sign. Pediatr Radiol 27, 124–129 (1997). https://doi.org/10.1007/s002470050082

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s002470050082

Keywords

Search

Navigation