Perineural Invasion and Spread in Common Abdominopelvic Diseases: Imaging Diagnosis and Clinical Significance

• DOI: 10.1148/rg.220148
• Publication Date: 2023-06-15T16:52:55Z
• Authors: Wendy Tu; Ravi V. Gottumukkala; Nicola Schieda; Luke Lavallée; Benjamin A. Adam; Stuart G. Silverman
• Keywords: Hypogastric nerve

Malignancies and other diseases may spread by multiple pathways, including direct extension, hematogenous spread, or via lymphatic vessels. A less-well-understood route is the peripheral nervous system, which known as perineural (PNS). In addition to accounting for pain neurologic symptoms, PNS affects both disease prognosis management. Although commonly discussed in relation head neck tumors, there emerging data regarding abdominopelvic malignancies conditions such endometriosis. Due improved contrast spatial resolution, invasion, a finding heretofore diagnosed only at pathologic examination, can be detected CT, MRI, PET/CT. most manifests abnormal soft-tissue attenuation extending along neural structures, diagnosis of it aided optimizing imaging parameters, understanding pertinent anatomy, becoming familiar with typical pathways that largely depend on type location. abdomen, celiac plexus central structure innervates major abdominal organs principal patients pancreatic biliary carcinomas. pelvis, lumbosacral inferior hypogastric are structures routes pelvic malignancies. findings subtle, radiologic have substantial effect patient care. Knowledge anatomy parameters utmost importance providing key information treatment planning. © RSNA, 2023 Supplemental material slide presentation from RSNA Annual Meeting available this article. Quiz questions article through Online Learning Center.