Neurofibromas may appear as solitary tumors or, in patients with neurofibromatosis, as multiple tumors affecting spinal nerve roots at multiple levels.

Imaging Studies

The appearance of neurofibromas on imaging studies may have the same characteristics as that of schwannomas: they may be isodense to the spinal cord on CT and enhance after contrast administration. On MRI they are usually isointense on T1WI and, at times, a target sign may appear with central hypointensity surrounded by a hyperintense peripheral rim. These tumors may enhance homogeneously following contrast administration (Figure 11-23). They may grow to a large size and bring about bone remodeling resulting in thinning of the pedicles, enlarged neural foraminae, and scalloped vertebral bodies.

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