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Hyang Sook Jeong - One of the best experts on this subject based on the ideXlab platform.

  • Benign peripheral nerve sheath tumor of digit versus major-nerve: Comparison of MRI findings
    PloS one, 2020
    Co-Authors: Seul Ki Lee, Jee-young Kim, Hyang Sook Jeong
    Abstract:

    Objective To compare the symptoms and magnetic resonance imaging (MRI) findings between digital peripheral nerve sheath tumor (PNST) and major-nerve PNST. Methods A total 36 cases with benign PNSTs (16 digital, 20 major-nerve) were enrolled. Chief complaint and Tinel Sign were reviewed. Five classic MRI features of PNST, the Signal intensity (SI), the enhancement, and the shape of tumor were evaluated on MRI. Results Half of each group showed tenderness. Tinel Sign was less frequent in digital PNST (12.5%) than major-nerve PNST (95.0%, P < 0.001). Split fat Sign, entering and exiting nerve, target Sign, and thin hyperintense rim were only observed in major-nerve PNST (P =

  • benign peripheral nerve sheath tumor of digit versus major nerve comparison of mri findings
    PLOS ONE, 2020
    Co-Authors: Seul Ki Lee, Jee-young Kim, Hyang Sook Jeong
    Abstract:

    OBJECTIVE To compare the symptoms and magnetic resonance imaging (MRI) findings between digital peripheral nerve sheath tumor (PNST) and major-nerve PNST. METHODS A total 36 cases with benign PNSTs (16 digital, 20 major-nerve) were enrolled. Chief complaint and Tinel Sign were reviewed. Five classic MRI features of PNST, the Signal intensity (SI), the enhancement, and the shape of tumor were evaluated on MRI. RESULTS Half of each group showed tenderness. Tinel Sign was less frequent in digital PNST (12.5%) than major-nerve PNST (95.0%, P < 0.001). Split fat Sign, entering and exiting nerve, target Sign, and thin hyperintense rim were only observed in major-nerve PNST (P = <0.001, <0.001, 0.492, and 0.002, respectively). Fascicular Sign was found in digital PNSTs (31.3%), but more frequent in major-nerve PNST (P < 0.001). In digital PNSTs, mild hyperintense SIs (56.2%) on T1-weighted images (T1-WI) was noted, but none in major-nerve PNST (P < 0.001). Both groups showed hyperintense SIs on T2-WI (P = 0.371). Homogeneity on T2-WI was noted in 43.8% of digital PNSTs, but none in major-nerve PNSTs (P = 0.004). Both groups showed heterogeneous enhancement (P = 0.066), but four (25%) digital PNSTs showed homogeneous enhancement. Lobulated shape was noted in 50% of digital PNSTs but none of major-nerve PNSTs (P = 0.001). Digital nerve was involved at 81.3% of digital PNSTs. Three foot cases showed unusual manifestations: bone destruction, skin thickening, and subungual location. CONCLUSION In digital PNSTs, Tinel Sign is not commonly found and classic MRI findings is insufficient. In addition, some digital PNSTs show different SI and enhancement from major-nerve PNSTs. However, digital soft tissue tumor involving digital neurovascular bundle and especially representing a fascicular Sign should be considered the possibility of a digital PNST.

Michael S. Cartwright - One of the best experts on this subject based on the ideXlab platform.

  • Ultrasonographic Tinel Sign.
    Muscle & nerve, 2009
    Co-Authors: Joseph N. Chipman, Ryan T. Mott, Constance A. Stanton, Michael S. Cartwright
    Abstract:

    High-resolution ultrasound has become increasingly useful in the evaluation of peripheral nerves. As we have gained experience, clinically helpful ultrasonographic Signs have been detected. One of these is the ultrasonographic Tinel Sign, in which paresthesias are produced when the transducer compresses a nerve lesion. This Sign has not been previously described. We present a case in which the ultrasonographic Tinel Sign helped accurately guide a nerve biopsy in a woman with mononeuritis multiplex.

Seul Ki Lee - One of the best experts on this subject based on the ideXlab platform.

  • Benign peripheral nerve sheath tumor of digit versus major-nerve: Comparison of MRI findings
    PloS one, 2020
    Co-Authors: Seul Ki Lee, Jee-young Kim, Hyang Sook Jeong
    Abstract:

    Objective To compare the symptoms and magnetic resonance imaging (MRI) findings between digital peripheral nerve sheath tumor (PNST) and major-nerve PNST. Methods A total 36 cases with benign PNSTs (16 digital, 20 major-nerve) were enrolled. Chief complaint and Tinel Sign were reviewed. Five classic MRI features of PNST, the Signal intensity (SI), the enhancement, and the shape of tumor were evaluated on MRI. Results Half of each group showed tenderness. Tinel Sign was less frequent in digital PNST (12.5%) than major-nerve PNST (95.0%, P < 0.001). Split fat Sign, entering and exiting nerve, target Sign, and thin hyperintense rim were only observed in major-nerve PNST (P =

  • benign peripheral nerve sheath tumor of digit versus major nerve comparison of mri findings
    PLOS ONE, 2020
    Co-Authors: Seul Ki Lee, Jee-young Kim, Hyang Sook Jeong
    Abstract:

    OBJECTIVE To compare the symptoms and magnetic resonance imaging (MRI) findings between digital peripheral nerve sheath tumor (PNST) and major-nerve PNST. METHODS A total 36 cases with benign PNSTs (16 digital, 20 major-nerve) were enrolled. Chief complaint and Tinel Sign were reviewed. Five classic MRI features of PNST, the Signal intensity (SI), the enhancement, and the shape of tumor were evaluated on MRI. RESULTS Half of each group showed tenderness. Tinel Sign was less frequent in digital PNST (12.5%) than major-nerve PNST (95.0%, P < 0.001). Split fat Sign, entering and exiting nerve, target Sign, and thin hyperintense rim were only observed in major-nerve PNST (P = <0.001, <0.001, 0.492, and 0.002, respectively). Fascicular Sign was found in digital PNSTs (31.3%), but more frequent in major-nerve PNST (P < 0.001). In digital PNSTs, mild hyperintense SIs (56.2%) on T1-weighted images (T1-WI) was noted, but none in major-nerve PNST (P < 0.001). Both groups showed hyperintense SIs on T2-WI (P = 0.371). Homogeneity on T2-WI was noted in 43.8% of digital PNSTs, but none in major-nerve PNSTs (P = 0.004). Both groups showed heterogeneous enhancement (P = 0.066), but four (25%) digital PNSTs showed homogeneous enhancement. Lobulated shape was noted in 50% of digital PNSTs but none of major-nerve PNSTs (P = 0.001). Digital nerve was involved at 81.3% of digital PNSTs. Three foot cases showed unusual manifestations: bone destruction, skin thickening, and subungual location. CONCLUSION In digital PNSTs, Tinel Sign is not commonly found and classic MRI findings is insufficient. In addition, some digital PNSTs show different SI and enhancement from major-nerve PNSTs. However, digital soft tissue tumor involving digital neurovascular bundle and especially representing a fascicular Sign should be considered the possibility of a digital PNST.

Henk J Coert - One of the best experts on this subject based on the ideXlab platform.

  • validity of the Tinel Sign and prevalence of tibial nerve entrapment at the tarsal tunnel in both diabetic and nondiabetic subjects a cross sectional study
    Plastic and Reconstructive Surgery, 2018
    Co-Authors: Willem D Rinkel, Manuel Castro Cabezas, Johan W Van Neck, Erwin Birnie, Steven E R Hovius, Henk J Coert
    Abstract:

    BACKGROUND: Nerve entrapments like carpal tunnel syndrome are more prevalent in patients with diabetes, especially in those with diabetic polyneuropathy. Our study aims were to investigate the validity of the Tinel Sign in diagnosing tibial neuropathy and determine the prevalence of tibial nerve entrapment in both a diabetic and nondiabetic population. METHODS: Two hundred forty nonneuropathic subjects with diabetes and 176 diabetic subjects with neuropathy participating in the prospective Rotterdam Diabetic Foot Study and 196 reference subjects without diabetes and without neuropathy complaints were evaluated. All subjects underwent sensory testing of the feet, and complaints were assessed using the Michigan Neuropathy Screening Instrument. The Tinel Sign was defined as discriminative and valid for diagnosing tibial nerve entrapment when the nerve-related Michigan Neuropathy Screening Instrument subscore of neuropathic symptoms differed at least 5 percent between the Tinel-positive and Tinel-negative subjects. When the Sign was valid, prevalence estimates of tibial nerve entrapment at the tarsal tunnel were calculated. RESULTS: Significantly more neuropathic symptoms (p < 0.002) and higher sensory thresholds (p < 0.0005) were observed in (compressed) tibial nerve-innervated areas, indicating that a positive Tinel Sign at the tarsal tunnel is a valid measure of tibial nerve abnormality. The prevalence of tibial nerve entrapment in diabetic patients was 44.9 percent (95 percent CI, 40.1 to 49.7 percent) versus 26.5 percent (95 percent CI, 20.3 to 32.7 percent) in healthy controls (p < 0.0001). CONCLUSIONS: Tibial nerve entrapment is more prevalent in diabetic subjects than in controls. The Significantly more frequently reported neuropathic complaints and concomitant sensory disturbances provide evidence for the role of superimposed entrapment neuropathy in diabetes-related neuropathy. CLINICAL QUESTION/LEVEL OF EVIDENCE: Diagnostic, IV.

Piotr Ziółkowski - One of the best experts on this subject based on the ideXlab platform.

  • Peripheral nerve tumours: 30-year experience in the surgical treatment
    Neurosurgical Review, 2015
    Co-Authors: Jerzy Gosk, Olga Gutkowska, Piotr Mazurek, Magdalena Koszewicz, Piotr Ziółkowski
    Abstract:

    Peripheral nerve tumours are relatively rare type of soft tissue tumours. The aim of this work is to present our experience with surgical treatment of this type of lesions. Clinical material consists of 94 patients (56 females, 38 males), in whom 101 tumours deriving from peripheral nervous system were removed. The patients underwent surgical treatment between 1983 and 2012. Tumours occurred mainly in the upper extremity (72 tumours), less often in the lower extremity (25 tumours). Lesions developed in major peripheral nerves (51 tumours) and small nerve branches (50 tumours). The most common symptoms reported before surgery included presence of tumour mass (100 %), positive Hoffmann-Tinel Sign (95.6 %) and paraesthesia (93.4 %). Less often sensory deficit (89.1 %) and pain (71.7 %) were observed. Motor deficit was the least common manifestation (41.3 %). Benign tumours prevailed in presented material (94 tumours). In 7 cases, malignant peripheral nerve sheath tumour (MPNST) was identified. As a result of surgical treatment in the group of tumours deriving from major peripheral nerves, in 87.8 % of the patients, pain relief was achieved; in 84 %, Hoffmann-Tinel Sign was negative; and in 79 %, paraesthesia resolved. Sensory function improvement was observed in 51.2 % of the patients while motor function improved in 26.3 % of the patients. None of the patients experienced tumour relapse. In the group of tumours deriving from small nerve branches, 47 patients had no Signs of tumour recurrence. One female patient diagnosed with MPNST suffered a relapse. Obtaining satisfactory results of peripheral nerve tumour treatment requires both careful differential diagnosis and well thought-out strategy at every stage of therapeutic management.

  • Results of Surgical Treatment of Schwannomas Arising from Extremities
    Hindawi Limited, 2015
    Co-Authors: Jerzy Gosk, Olga Gutkowska, Maciej Urban, Witold Wnukiewicz, Paweł Reichert, Piotr Ziółkowski
    Abstract:

    Schwannomas are benign neoplasms derived from Schwann cells. In this work, we present our experience in operative management of schwannomas and analyse results of treatment. Clinical material consisted of 34 patients, in whom 44 schwannomas located in extremities were excised between 1985 and 2013. Thirty-five tumours originated from major peripheral nerves and 9 from small nerve branches. Postoperatively, in the first group of tumours, pain resolved in 100%, paresthesias in 83.3%, and Hoffmann-Tinel Sign in 91.6% of the patients. Improvement in motor function was noted in 28.5% of the cases, in sensory function: complete in 70%, and partial in 15%. The most frequently affected major peripheral nerves were the ulnar (11 tumours) and median (5 tumours) nerves. Schwannomas originating from small nerve branches were removed without identification of the site of origin. After their resection, definitive healing was achieved. Conclusions. (1) Schwannomas located in extremities arise predominantly from major peripheral nerves, most commonly the ulnar and median nerves. (2) Gradual tumour growth causes exacerbation of compression neuropathy, creating an indication for surgery. (3) In most cases, improvement in peripheral nerve function after excision of schwannoma is achieved. (4) The risk of new permanent postoperative neurological deficits is low