Imaging of chordomas of the mobile spine

In this retrospective study twelve histologically confirmed cases of spinal chordoma have been reviewed. Plain radiographs were performed in all cases, and CT scans in 11 patients. Four patients had post-myelography CT. Five patients were explored by MRI, and two had a post-DOTA-gadolinium MR study. Ten patients underwent spinal arteriography. Cervical spine chordomas (3 cases) were osteolytic, developed laterally to the vertebral body and involved one of more adjacent vertebrae. Thoracic and lumbar chordomas (9 cases) were usually centrally located in the vertebral body with no adjacent involvement and presented as osteo-sclerotic or mixed osteolytic-osteosclerotic lesions. CT scans provide a good view of the extravertebral component of the tumour, but MRI is the best imaging method to evaluate tumoral extension. Intravenous gadolinium injection seems to produce a better delineation of the epidural extent of the tumour at cervical level. Angiography remains useful for presurgical evaluation.