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Intramedullary spinal cord tumors: significance of associated hemorrhage at MR imaging
Abstract:
Magnetic resonance (MR) images obtained in 35 patients with intramedullary spinal tumors were reviewed. Hypointense areas on both T1- and T2-weighted images were seen within or around eight tumors, all of which were in the cervical cord. Hypointensity at the tumor margin was seen in seven cases. Hypointensity within the tumor was seen in two cases. (One case had both types of hypointensity). In seven surgically confirmed cases, hypointensity at the tumor margin was found to be a relatively firm pseudocapsule, and hypointensity within the tumor corresponded to intratumoral hematoma. All of the tumors with hypointensity were ependymomas at histologic examination. When MR imaging shows an intramedullary tumor with hypointensity at the tumor margin, it is suggestive, but not pathognomonic, of an ependymoma.
Insights
Magnetic resonance (MR) imaging of intramedullary spinal tumors revealed hypointense areas suggestive of ependymomas. Specifically, hypointensity at the tumor margin often indicates a pseudocapsule, a key finding for this tumor type.
Area of Science:
- Neuroradiology
- Oncology
- Spinal Cord Imaging
Background:
- Intramedullary spinal tumors represent a diverse group of neoplasms.
- Accurate preoperative diagnosis is crucial for effective treatment planning.
- Magnetic resonance (MR) imaging is the primary modality for evaluating these lesions.
Purpose of the Study:
- To investigate the MR imaging characteristics of intramedullary spinal tumors.
- To determine the significance of hypointense areas on MR images in the diagnosis of these tumors.
- To correlate imaging findings with histopathological diagnoses.
Main Methods:
- Retrospective review of MR images from 35 patients with intramedullary spinal tumors.
- Analysis of T1- and T2-weighted images for hypointense areas within or around tumors.
- Correlation of imaging findings with surgical and histopathological results.
Main Results:
- Hypointense areas were observed in 8 of 35 tumors, predominantly in the cervical cord.
- Hypointensity at the tumor margin was present in 7 cases and correlated with a pseudocapsule.
- Hypointensity within the tumor was seen in 2 cases and corresponded to intratumoral hematoma.
- All tumors exhibiting hypointensity were histopathologically confirmed as ependymomas.
Conclusions:
- Hypointensity at the tumor margin on MR imaging is suggestive of an ependymoma.
- While not pathognomonic, this finding aids in the preoperative differentiation of intramedullary spinal tumors.
- MR imaging features, including hypointensity, are valuable in characterizing spinal cord lesions.