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Congress: ECR26
Poster Number: C-22989
Type: Poster: EPOS Radiologist (educational)
Authorblock: Y. A. Salah, M. Abouelela; Alexandria/EG
Disclosures:
Yomna Ahmed Salah: Nothing to disclose
Mohamed Abouelela: Nothing to disclose
Keywords: Abdomen, Anatomy, Pelvis, CT, MR, Radiation therapy / Oncology, Cancer
Learning objectives Recognize perineural spread as a distinct route of tumor extension in abdominal and pelvic malignancies. Knowledge of anatomy and pathways of perineural spread in abdomen and pelvis. Familiarity with common abdominal malignancies associated with perineural spread. Radiological features of perineural spread on different modalities.
Read more Background Beyond the conventional routes of direct extension, hematogenous, and lymphatic spread, tumors may also propagate along peripheral nerves, a process known as perineural spread (PNS). Historically identifiable only on pathology, PNS can now be detected using CT, MRI, and PET/CT. Accurate diagnosis requires a thorough understanding of the relevant anatomy and familiarity with characteristic routes of spread, which vary according to tumor type and location. PNS is well-recognized in head and neck cancers, where radiologists are highly familiar with detailed...
Read more Findings and procedure details CT offers several advantages for detecting PNS, including superior spatial resolution, reduced sensitivity to motion, excellent fat–soft tissue contrast, and clear depiction of blood vessels that commonly run alongside nerves. In the upper abdomen, nerves are generally small and sparse to be directly visualized, making arterial branches reliable surrogates for neural pathways. Because recognition of PNS in this region relies on detecting subtle changes in the fat planes surrounding these vessels, CT outperforms MRI for evaluation of upper abdominal PNS.In...
Read more Conclusion Perineural spread is an important yet relatively under-recognized imaging manifestation of abdominal and pelvic diseases, most commonly of neoplastic origin. Its detection can be challenging, as imaging findings are often subtle, but a thorough understanding of relevant anatomy and neural pathways, greatly improves diagnostic accuracy. Identifying PNS carries significant prognostic implications and can directly influence patient management. Early recognition is therefore critical for both optimizing oncologic outcomes and improving patient quality of life.
Read more References https://pubs.rsna.org/doi/full/10.1148/rg.220148
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