Thakur Uma, Ramachandran Shyam, Mazal Alexander T, Cheng Jonathan, Le Lu, Chhabra Avneesh
Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75235, USA.
Department of Radiology, Stanford University School of Medicine, Palo Alto, CA, USA.
Skeletal Radiol. 2025 Mar;54(3):407-422. doi: 10.1007/s00256-024-04765-6. Epub 2024 Aug 6.
Neurofibromatosis (NF) type I is a neuroectodermal and mesodermal dysplasia caused by a mutation of the neurofibromin tumor suppressor gene. Phenotypic features of NF1 vary, and patients develop benign peripheral nerve sheath tumors and malignant neoplasms, such as malignant peripheral nerve sheath tumor, malignant melanoma, and astrocytoma. Multiparametric whole-body MR imaging (WBMRI) plays a critical role in disease surveillance. Multiparametric MRI, typically used in prostate imaging, is a general term for a technique that includes multiple sequences, i.e. anatomic, diffusion, and Dixon-based pre- and post-contrast imaging. This article discusses the value of multiparametric WBMRI and illustrates the spectrum of whole-body lesions of NF1 in a single imaging setting. Examples of lesions include those in the skin (tumors and axillary freckling), soft tissues (benign and malignant peripheral nerve sheath tumors, visceral plexiform, and diffuse lesions), bone and joints (nutrient nerve lesions, non-ossifying fibromas, intra-articular neurofibroma, etc.), spine (acute-angled scoliosis, dural ectasia, intraspinal tumors, etc.), and brain/skull (optic nerve glioma, choroid plexus xanthogranuloma, sphenoid wing dysplasia, cerebral hamartomas, etc.). After reading this article, the reader will gain knowledge of the variety of lesions encountered with NF1 and their WBMRI appearances. Timely identification of such lesions can aid in accurate diagnosis and appropriate patient management.
I型神经纤维瘤病(NF)是一种由神经纤维瘤蛋白肿瘤抑制基因突变引起的神经外胚层和中胚层发育异常。NF1的表型特征各不相同,患者会出现良性周围神经鞘瘤和恶性肿瘤,如恶性周围神经鞘瘤、恶性黑色素瘤和星形细胞瘤。多参数全身磁共振成像(WBMRI)在疾病监测中起着关键作用。多参数MRI通常用于前列腺成像,是一种包括多个序列的技术的统称,即解剖成像、扩散成像以及基于狄克逊法的对比剂前和对比剂后成像。本文讨论了多参数WBMRI的价值,并在单一成像环境中展示了NF1全身病变的范围。病变示例包括皮肤病变(肿瘤和腋窝雀斑)、软组织病变(良性和恶性周围神经鞘瘤、内脏丛状病变和弥漫性病变)、骨与关节病变(营养神经病变、非骨化性纤维瘤、关节内神经纤维瘤等)、脊柱病变(锐角脊柱侧弯、硬脊膜扩张、椎管内肿瘤等)以及脑/颅骨病变(视神经胶质瘤、脉络丛黄色肉芽肿、蝶骨翼发育异常、脑错构瘤等)。阅读本文后,读者将了解NF1所涉及的各种病变及其WBMRI表现。及时识别这些病变有助于准确诊断和对患者进行适当管理。