Multiparametric whole-body MRI of patients with neurofibromatosis type I: spectrum of imaging findings.

Jonathan Cheng, Uma Thakur, Shyam Ramachandran, Alexander T Mazal, Lu Le, Avneesh Chhabra

Journal: Skeletal radiology 2025;54(3):407-422

PMID: 39105762

Abstract

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.

© 2024. The Author(s), under exclusive licence to International Skeletal Society (ISS).

Address: 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.; Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, TX, USA.; Department of Dermatology and Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, USA.; Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75235, USA. [email protected].; Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, TX, USA. [email protected].

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