Peripheral nerve tractography in soft tissue tumors: a preliminary 3-tesla diffusion tensor magnetic resonance imaging study

Muscle Nerve. 2015 Mar;51(3):338-45. doi: 10.1002/mus.24313. Epub 2015 Jan 5.

Abstract

Introduction: This diffusion tensor magnetic resonance imaging (DTI) study aimed to clarify the relationship of peripheral nerves and soft tissue tumors (STTs) in 3D to optimize subsequent treatment.

Methods: Twenty-six consecutive STT patients (histologically malignant, n=10; intermediate, n=3; and benign, n=13) underwent 3-Tesla MRI using an echoplanar DTI sequence. Deterministic tractography was performed. Fractional anisotropy (FA) values were measured within peritumoral and distant regions of interest.

Results: Tractography depicted the 3D course of the sciatic (n=12), femoral (n=2), tibial (n=7), fibular (n=2), median (n=1), musculocutaneous (n=1), and ulnar (n=1) nerves in a regular (n=8 of 18, 44.4%) or thinned (n=7 of 18, 38.9%) fashion. The lowest peritumoral FA values, abrupt thinning, and/or complete discontinuity of trajectories were found in 2 cases with histologically proven tumoral nerve infiltration.

Conclusions: DTI clarifies the 3D topography between major peripheral nerves and STTs and may be helpful in the assessment of peripheral nerve infiltration by malignant tumors.

Keywords: diffusion tensor imaging; nerve lesion; peripheral nerve imaging; peripheral nerve tumors; schwannoma; soft tissue neoplasm.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Diffusion Tensor Imaging / methods*
  • Female
  • Humans
  • Imaging, Three-Dimensional / methods*
  • Male
  • Middle Aged
  • Peripheral Nerves / metabolism
  • Peripheral Nerves / pathology*
  • Prospective Studies
  • Soft Tissue Neoplasms / diagnosis*
  • Soft Tissue Neoplasms / metabolism
  • Young Adult