ORIGINAL RESEARCH article
Front. Oncol.
Sec. Cancer Imaging and Image-directed Interventions
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1692893
Fusion of Contrast-Enhanced Magnetic Resonance Neurography and T1-Weighted Imaging Improves Simultaneous Nerve-Tumor Visualization in Head and Neck Lesions
Provisionally accepted
Tingting LiuZhiqing Zhang
Yuan LiuYu SuQun YuChungao LiXiangchuang Kong
Jie ZhaoShuo Huang
Chuansheng Zheng
Wenjun Wu*
Lixia Wang*- Huazhong University of Science and Technology, Wuhan, China
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Objective: To investigate the application value of integrating contrast-enhanced magnetic resonance neurography (CE-MRN) with contrast-enhanced T1-weighted imaging (CE-T1WI) to improve the simultaneous imaging of nerves and tumors in the head and neck. Materials and Methods: A retrospective study of 31 patients (14 neurogenic, 17 non-neurogenic) with pathologically confirmed peripheral nerve tumors (2017–2024) was conducted. All underwent 3.0 T MRI, assessed by two blinded radiologists. Tumor involvement patterns, enhancement features, MRI signs, and normalized nerve signal intensity were analyzed. Diagnostic confidence and lesion conspicuity were compared across CE-MRN, CE-T1WI, and fusion images. Statistical analysis included Mann-Whitney U test and interobserver agreement (Kappa/ICC). Results: Interobserver agreement was moderate to excellent (Kappa/ICC: 0.47-0.93). Focal involvement dominated in neurogenic tumors (92.9% vs. 52.9% diffuse in non-neurogenic, p=0.002). Traditional MRI signs: "dumbbell sign" was more frequent in neurogenic tumors (78.6% vs. 11.8%, p<0.001), while "effacement of fat plane" was common in non-neurogenic (70.6% vs. 0%, p<0.001). Novel CE-MRN signs: "enhanced target sign" (28.6% vs. 0%, p=0.032) and "nerve tail sign" (57.1% vs. 11.8%, p=0.018) were neurogenic markers, whereas "nerve effacing sign" was non-neurogenic (76.5% vs. 35.7%, p=0.033). Affected nerves showed higher signal intensity than contralateral nerves (p<0.05). Fusion images matched CE-MRN in diagnostic confidence and surpassed CE-T1WI in conspicuity (p<0.001). Conclusion: Image fusion technology addressed the limitations of CE-MRN in lesion visualization, thereby enhancing diagnostic confidence. The novel signs and nerve signal alterations observed in CE-MRN provide visual evidence for the accurate diagnosis and differentiation of head and neck tumors.
Keywords: Contrast-enhanced magnetic resonance neuroimaging, Peripheral nerve tumors, Imagefusion technology, Neurogenic tumors, non-neurogenic tumors
Received: 03 Sep 2025; Accepted: 06 Oct 2025.
Copyright: © 2025 Liu, Zhang, Liu, Su, Yu, Li, Kong, Zhao, Huang, Zheng, Wu and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Wenjun Wu, wuhan_wuwj@163.com
Lixia Wang, lisa2003627_1@163.com
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