MRI of extradural spinal tumours at 0.3 T

Ninety-one patients with extradural spinal tumours were examined by magnetic resonance imaging. There were 76 metastases (6 from unknown primary tumours). Seven patients had primary spinal tumours and 8 had multiple myeloma. Sixteen had bulging, diseased vertebral bodies compressing the subarachnoid space and 67 had extradural tumour compressing the spinal cord. Sixty patients had paravertebral involvement. Intraspinal involvement did not correlate with the extent of spinal lesions. All patients had vertebral destruction, with hypointense or combined hypo- and isointense signal relative to bone marrow on T1-weighted images. In most of the 22 patients with T2-weighted images the tumours were isointense or slightly hyperintense. It was usually impossible to differentiate the various tumours on the basis of signal intensity and morphology. However, metastases from carcinoma of the prostate were often more hypointense than other tumours on T1- and T2-weighted images. An inhomogeneous pattern in which diffusely low signal is combined with focal lower signal on T1-weighted images may suggest myeloma. In the 22 patients examined with both T1- and T2-weighted images, T1-weighted images gave the best information in 18; in 3 they were equivalent and in 1 inferior to T2-weighted images; they are therefore recommended for routine imaging of epidural spinal tumours.