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High-resolution ultrasonography and shear-wave sonoelastography of a cystic radial nerve Schwannoma


Peripheral nerve tumors are often evaluated with magnetic resonance imaging (MRI), although there are many advantages offered with high-resolution ultrasonography (HRUS). This case report emphasizes the value of HRUS in the diagnosis and management of a patient with a cystic radial nerve Schwannoma. In addition, information on tumor stiffness, obtained with shear-wave sonoelastography (SWE), is presented.


I tumori dei nervi periferici vengono spesso studiati con la risonanza magnetica (MRI), anche se l’ecografia ad alta risoluzione (HRUS) presenta molti vantaggi. Questo case report sottolinea il valore della HRUS nella diagnosi e nella gestione di un paziente con uno Schwannoma cistico del nervo radiale. Vengono inoltre riferite le informazioni sulla stiffness del tumore ottenute con la shear wave elastosonografia.

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  1. Kransdorf MJ (1995) Benign soft-tissue tumors in a large referral population: distribution of specific diagnoses by age, sex, and location. AJR Am J Roentgenol 164(2):395–402. doi:10.2214/ajr.164.2.7839977

    Article  CAS  PubMed  Google Scholar 

  2. Kim DH, Murovic JA, Tiel RL, Moes G, Kline DG (2005) A series of 397 peripheral neural sheath tumors: 30-year experience at Louisiana State University Health Sciences Center. J Neurosurg 102(2):246–255. doi:10.3171/jns.2005.102.2.0246

    Article  PubMed  Google Scholar 

  3. Zhang H, Li Y, Shao J, Chen W, Wang Y (2016) High-resolution ultrasound of Schwannomas of the limbs: analysis of 72 Cases. Ultrasound Med Biol 42(11):2538–2544. doi:10.1016/j.ultrasmedbio.2016.06.006

    Article  PubMed  Google Scholar 

  4. Adani R, Tarallo L, Mugnai R, Colopi S (2014) Schwannomas of the upper extremity: analysis of 34 cases. Acta Neurochir 156(12):2325–2330. doi:10.1007/s00701-014-2218-2

    Article  PubMed  Google Scholar 

  5. Isobe K, Shimizu T, Akahane T, Kato H (2004) Imaging of ancient Schwannoma. AJR Am J Roentgenol 183(2):331–336. doi:10.2214/ajr.183.2.1830331

    Article  PubMed  Google Scholar 

  6. Murphey MD, Smith WS, Smith SE, Kransdorf MJ, Temple HT (1999) From the archives of the AFIP. Imaging of musculoskeletal neurogenic tumors: radiologic-pathologic correlation. Radiographics 19(5):1253–1280. doi:10.1148/radiographics.19.5.g99se101253

    Article  CAS  PubMed  Google Scholar 

  7. Lee FC, Singh H, Nazarian LN, Ratliff JK (2011) High-resolution ultrasonography in the diagnosis and intraoperative management of peripheral nerve lesions. J Neurosurg 114(1):206–211. doi:10.3171/2010.2.JNS091324

    Article  PubMed  Google Scholar 

  8. Ali ZS, Pisapia JM, Ma TS, Zager EL, Heuer GG, Khoury V (2016) Ultrasonographic evaluation of peripheral nerves. World Neurosurg 85:333–339. doi:10.1016/j.wneu.2015.10.005

    Article  PubMed  Google Scholar 

  9. Zaidman CM, Seelig MJ, Baker JC, Mackinnon SE, Pestronk A (2013) Detection of peripheral nerve pathology: comparison of ultrasound and MRI. Neurology 80(18):1634–1640. doi:10.1212/WNL.0b013e3182904f3f

    Article  PubMed  PubMed Central  Google Scholar 

  10. Kim H, Kim JA, Son EJ, Youk JH (2013) Quantitative assessment of shear-wave ultrasound elastography in thyroid nodules: diagnostic performance for predicting malignancy. Eur Radiol 23(9):2532–2537. doi:10.1007/s00330-013-2847-5

    Article  PubMed  Google Scholar 

  11. Wang F, Chang C, Gao Y, Chen YL, Chen M, Feng LQ (2016) Does shear wave elastography provide additional value in the evaluation of thyroid nodules that are suspicious for malignancy? J Ultrasound Med 35(11):2397–2404. doi:10.7863/ultra.15.09009

    Article  PubMed  Google Scholar 

  12. Toia F, Gagliardo A, D’Arpa S, Gagliardo C, Gagliardo G, Cordova A (2016) Preoperative evaluation of peripheral nerve injuries: what is the place for ultrasound? J Neurosurg 125(3):603–614. doi:10.3171/2015.6.JNS151001

    Article  PubMed  Google Scholar 

  13. Nilsson J, Sandberg K, Soe Nielsen N, Dahlin LB (2009) Magnetic resonance imaging of peripheral nerve tumours in the upper extremity. Scand J Plast Reconstr Surg Hand Surg 43(3):153–159. doi:10.1080/02844310902734572

    Article  PubMed  Google Scholar 

  14. Simon NG, Cage T, Narvid J, Noss R, Chin C, Kliot M (2014) High-resolution ultrasonography and diffusion tensor tractography map normal nerve fascicles in relation to Schwannoma tissue prior to resection. J Neurosurg 120(5):1113–1117. doi:10.3171/2014.2.JNS131975

    Article  PubMed  Google Scholar 

  15. Cage TA, Yuh EL, Hou SW, Birk H, Simon NG, Noss R et al (2015) Visualization of nerve fibers and their relationship to peripheral nerve tumors by diffusion tensor imaging. Neurosurg Focus 39(3):E16. doi:10.3171/2015.6.FOCUS15235

    Article  PubMed  Google Scholar 

  16. Wasa J, Nishida Y, Tsukushi S, Shido Y, Sugiura H, Nakashima H et al (2010) MRI features in the differentiation of malignant peripheral nerve sheath tumors and neurofibromas. AJR Am J Roentgenol 194(6):1568–1574. doi:10.2214/AJR.09.2724

    Article  PubMed  Google Scholar 

  17. Li CS, Huang GS, Wu HD, Chen WT, Shih LS, Lii JM et al (2008) Differentiation of soft tissue benign and malignant peripheral nerve sheath tumors with magnetic resonance imaging. Clin Imaging 32(2):121–127. doi:10.1016/j.clinimag.2007.05.006

    Article  PubMed  Google Scholar 

  18. Costello JR, Kalb B, Martin DR (2016) Incidence and risk factors for gadolinium-based contrast agent immediate reactions. Topics Magn Reson Imaging TMRI. doi:10.1097/RMR.0000000000000109

    Google Scholar 

  19. Bae JS, Chang JM, Lee SH, Shin SU, Moon WK (2016) Prediction of invasive breast cancer using shear-wave elastography in patients with biopsy-confirmed ductal carcinoma in situ. Eur Radiol. doi:10.1007/s00330-016-4359-6

    Google Scholar 

  20. Giannotti E, Vinnicombe S, Thomson K, McLean D, Purdie C, Jordan L et al (1062) Shear-wave elastography and greyscale assessment of palpable probably benign masses: is biopsy always required? Br J Radiol 2016(89):20150865. doi:10.1259/bjr.20150865

    Google Scholar 

  21. Pass B, Johnson M, Hensor EM, Gupta H, Robinson P (2016) Sonoelastography of musculoskeletal soft tissue masses: a pilot study of quantitative evaluation. J Ultrasound Med 35(10):2209–2216. doi:10.7863/ultra.15.11065

    Article  PubMed  Google Scholar 

  22. Cantisani V, Orsogna N, Porfiri A, Fioravanti C, D’Ambrosio F (2013) Elastographic and contrast-enhanced ultrasound features of a benign Schwannoma of the common fibular nerve. J Ultrasound 16(3):135–138. doi:10.1007/s40477-013-0027-8

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Correspondence to Patrick J. Battaglia.

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The authors declare that they have no conflicts of interest to disclose.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. All ethical standards were upheld during both the imaging and surgical procedures inherent in this case.

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All patients provided written informed consent to enrollment in the study and to the inclusion in this article of information that could potentially lead to their identification. Patient informed consent was obtained prior to publication.

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Dynamic cine of the radial nerve in short axis moving caudally through its bifurcation demonstrates the origin of the Schwannoma to be from the deep branch of the radial nerve (AVI 108546 kb)

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Battaglia, P.J., Carbone-Hobbs, V., Guebert, G.M. et al. High-resolution ultrasonography and shear-wave sonoelastography of a cystic radial nerve Schwannoma. J Ultrasound 20, 261–266 (2017).

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