Department of Radiology, Princess Alexandra Hospital, and Queensland X-Ray, Brisbane, Queensland, Australia.
Head Neck. 2011 Apr;33(4):469-75. doi: 10.1002/hed.21470.
The accurate preoperative identification of the extent of perineural spread (PNS) of malignancy along a cranial nerve is vital to the design of an appropriate surgical resection. Our purpose was to determine the sensitivity of targeted MRI in predicting the presence of disease and the anatomic extent of spread when compared with histologic findings.
A retrospective review was performed of 25 patients with PNS who had targeted MRI and surgery to excise perineural tumor (2002-2008).
MRI detected PNS in 30 of 30 nerves (100%) with 1 false positive. MRI correctly identified the extent of spread based on histology in 25 of 30 nerves (83.3%). In 4 of 30 cases (13.3%) MRI underestimated the extent of spread proximal to the Gasserian ganglion that, if diagnosed preoperatively, may have deemed the patient inoperable.
MRI demonstrated the presence and anatomic extent of PNS in the majority of cases. MRI may underestimate microscopic spread proximal to the Gasserian ganglion.
准确术前识别颅神经周围神经蔓延（PNS）的恶性肿瘤的范围对于制定适当的手术切除至关重要。我们的目的是确定靶向 MRI 在预测疾病存在和与组织学发现相比的扩散解剖范围的敏感性。
回顾性分析了 25 例 PNS 患者，他们接受了靶向 MRI 检查和手术切除神经周围肿瘤（2002-2008 年）。
MRI 检测到 30 条神经中的 30 条（100%）存在 1 个假阳性。MRI 根据组织学正确识别了 30 条神经中的 25 条（83.3%）的扩散范围。在 30 例中，有 4 例（13.3%）MRI 低估了神经节近端的扩散范围，如果术前诊断，可能认为患者无法手术。
MRI 在大多数情况下显示了 PNS 的存在和解剖范围。MRI 可能低估了神经节近端的微观扩散。
