A radiological classification system for XXXX : assessment of potential for resection with high-resolution MRI.

@entity1 @entity455 @entity2695 @entity16 @entity14361 @entity2054 @entity1462
BACKGROUND: Intraneural @entity2695 and @entity1462 are rare, with approximately 50 cases reported in the literature. They present a therapeutic challenge; surgical resection can result in @entity16 and lesion recurrence is common. We introduce a new framework to classify @entity455 in relation to the anatomic compartments of the nerve and assess amenability to surgical resection. METHODS: We retrospectively reviewed cases of intraneural @entity2695 and @entity1462 treated at our institution between 2003 and 2013 that had high-resolution 3-T magnetic resonance imaging (MRI). A review of the literature was also performed. Our cases and reports in the literature with available MRI data were sub-categorized according to their relationship to the paraneurium and epineurium of the nerve. RESULTS: Nine @entity1 were identified with intraneural (subparaneurial or subepineurial) @entity455 . Two @entity1 had a predominantly subparaneurial involvement of the nerve, six @entity1 had predominantly @entity14361 , and one @entity1 exhibited extensive involvement in both compartments. Four @entity1 were managed surgically and the rest conservatively. Targeted resection of two @entity2695 provided complete relief of symptoms and freedom from recurrence at 18 month and 24 months respectively. One @entity1 with extensive @entity1462 did not appear to benefit from sub-total resection with interfascicular dissection. No surgical morbidity was noted in any of the cases. CONCLUSIONS: We believe that the subparaneurial compartment-a potential space between the epineurium and paraneurium-provides a tissue plane within which benign @entity455 can occur. @entity2695 and @entity1462 are complex and can occupy different @entity2054 . The anatomic framework aids surgical decision-making and ensures that all components of the lesion are considered. We advocate a multimodal approach in the treatment of these rare lesions.
