DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20151002

Magnetic resonance evaluation of intra dural spinal tumors with histopathology correlation

Uma Maheswara Rao, Bujji Babu Perisetti, Swetha Reddy, Jyothi Lalitha

Abstract


Background: Tumors of the spinal cord or canal constitute approximately 15% to 20% of central nervous system tumors. The differential diagnosis of spinal neoplasms is primarily based on location of the lesion relative to the spinal cord and the age, sex and clinical presentation. The aim and objective of the study was to determine the sensitivity of magnetic resonance imaging (MRI) in diagnosing intra spinal tumors and to correlate findings on MRI with histopathological diagnosis.

Methods: This is a retrospective study. The study group included all the patients who presented to our hospital with progressive sensory or motor deficits, para or quadriperesis with or without bladder/bowel Involvement. Only patients with Intra dural lesions such as intradural extra medullary and Intra medullary lesions were included in the study. All the extra dural lesion cases such as vertebral tumors, degenerative/osteoporotic compressions and Trauma related cord compressions were excluded from the study.

Results: Of the forty intradural tumors, 28 were extramedullary and 12 were intramedullary. Most of the tumors were located in the cervical and the dorsolumbar spine accounting for more than 50%. The most common tumor encountered in our study was schwannoma (22/40), followed by ependymoma (7/40), meningioma (4/40), astrocytoma (4/40), one each of Hemangioblastoma, Neuroentericcyst and Dermoid cyst. Ependymomas, Astrocytomas and hemangioblastoma were intramedullary lesions and the remaining lesions constituted Intra Dural extra medullary lesions.

Conclusions: MRI was found to be a highly sensitive imaging procedure and the method of choice for intradural tumor evaluation and to differentiate extra medullary from Intra medullary lesions. It is not sensitive enough to differentiate the Intra medullary tumors. Nevertheless, definite diagnosis could be made by histopathology only.

 


Keywords


MRI, Spinal cord tumors, Intradural lesions, Cord tumor histology

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References


Williams RS, Williams JP. Tumors. In Krishna CVG et al eds: MRI and CT of the spine, Baltimore, Williams and Wilkins. 1994:347-429.

Zimmerman RA, Bilanuik LT. Imaging of tumors of the spinal canal and cord. RCNA. 1988;26(5):965-1007.

Rapoport RJ, Flanders AE, Tartaglina LM. Intradural extramedullary causes of myelopathy. Sem in US, CT and MRI. 1994;15(3):189-225.

Masaryk TJ. Neoplastic disease of spine. RCNA. 1991;29(4):829-46.

Naffziger HC, Jones OW Jr. Dermoid tumors of the spinal cord. Report of 4 cases with observation on a clinical test for the differentiation of the source of radicular pain. Arch NeurolPsychiatr. 1935;33:941.

Scotti G, Scialfa G, Colombo N, Landoni L. MR imaging of intradural extramedullary tumors of the cervical spine. J Comp Asst Tomogr. 1985;9(6):1037-41.

Levine E, Huntrakoon M, Wetzel LH. Malignant nerve sheath neoplasms in neurofibromatosis - distinction from Benign tumors by using imaging techniques. AJR. 1987;149:1059-64.

Parizel PM, Balériaux D, Rodesch G, Segebarth C, Lalmand B, Christophe C, et al. Gd DTPA enhanced Magnetic Resonance Imaging of spinal tumors. AJR. 1989;10:249-58.

Breger RK, Williams AL, Daniels DL, Czervionke LF, Mark LP, Haughton VM, et al. Contrast enhancement in spinal MR Imaging. AJNR. 1989;10:633-7.

McCormick PC, Torres R, Post KD, Stein BM. Intramedullary ependymoma of the spinal cord. J Neurosurg. 1990;72(4):523-32.

Gulati P, Jena A, Tripathi RP, VeenaChowdhary, Khusu S. MRI of Intramedullary tumors. Indian Journal of Radio' Imag. 1991;1:17-20.

Isu T, Abe H, Iwasaki Y, Akino M, Koyanagi I, Hida K, et al. Diagnosis and surgical treatment of spinal hemanigoblastoma. Neurolsurg. 1991;19(2):149-55.

Brotchi JMD, Decutte 0, Levivier et al M. A survey of 65 tumors within the spinal cord. Surgical results and importance of preoperative MRI. Neurosurg 1991;29:651-57.

Hu HP, Huang QL. Signal intensity correlation of MRI with pathological findings in spinal neurinomas. Neuroradiol. 1992;34:98-102.

Demachi H, Takashima J, Kadoya M, Suzuki M, Konishi H, Tomita K, et al. MRI of spinal neurinomas with pathologic correlation. J Comp AsstTomogr. 1990;14:250-4.

Holocomb GW, Matson DD. Thoracic neurenteric cyst. Surgery. 1954;35:115-21.

Fortuna A, Mercuri S. Intradural Spinal cysts. ActaNeurochir (Wien). 1983;68:289-314.

Abul-Kasim K, Majda M, McKeever P, Pia C. Sundgren Intradural spinal tumors: current classification and MRI features. Neuroradiology. 2008;50:301-14.

Wagle WA, Jaugman B, Mincy JE. Intradural extrarnedullary ependymoma, MR pathological correlation. J Comp Asst Tomogr. 1988;12:705-7.