Magnetic resonance imaging spectrum of spinal meningioma
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Spinal Cord Neoplasm
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Magnetic resonance imaging (MRI) has become an important diagnostic tool in diagnosing spinal cord tumors. But differential diagnosis is very difficult with only MRI.Spinal meningiomas account for about 10% of primary spinal cord tumors in Asia. We studied three patients with spinal meningiomas in order to show special findings. T1-weighted images showed various intensities, but their signal intensities on T2-weighted images were similar to those of the spinal cord in all cases. We considered these to be special findings with MRI in spinal meningioma. The relationship between pathological type (e. g. psammomatous type, fibroblastic type, and transitional type) and MRI was not clear. Preoperative diagnosis of ossified spinal meningioma was made from MRI.
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Objective:To explore the magnetic resonance imaging(MRI)features of spinal meningiomas and evaluate their diagnostic value.Methods:Retrospective review of MR imaging data of 21 patients with pathologically proven spinal meningiomas was performed.Lesions were evaluated for site,shape,size,signal intensity,enhancement pattern,and the relationship between the tumor and adjacent structures.Results:Twenty-one spinal meningiomas were identified in 21 patients.The thoracic spine was involve in 14 cases, the cervical spine in 5 cases and the lumbar spine in two cases.All meningiomas were purely intradural extramedullary with a flat or oval shap,transverse diameter less than its longitudinal diameter,obtuse angle between the tumor and adjacent dura,and clear boundary on the side of the spinal cord.The signal intensity of the approximately 90%of lesions was isointense or slightly hypointense to the spinal cord on T1WIs and isointense or slightly hyperintense to the spinal cord on T2WIs.Sixteen cases(76.2%)were homogenous enhancement and 13 cases(61.9%)were meningeal tail sign after intravenous contrast material injection.Conclusions:The manifestation of the intraspinal meningioma is some extent characteristic on MR imaging.The shape,signal intensity and enhancement pattern of the lesion play the same important roles in the qualitative diagnosis of spinal meningioma.
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We report a case of spinal clear-cell meningioma occurring in a 22-month-old male who presented a right limp and then refused to walk. Spinal magnetic resonance imaging demonstrated a large, intradural tumor from T<sub>11</sub> to L<sub>4</sub>, which was totally excised. The patient’s postoperative recovery was uneventful and 5 months after surgery he began walking again. The latest follow-up magnetic resonance imaging of the brain and spine, obtained 42 months after diagnosis, was negative for tumor recurrence. Though clear-cell meningioma is a rare form of meningioma, it should be considered in the differential diagnosis of any space-occupying lesion of the spine arising in very young children. Complete surgical removal is necessary because it is potentially aggressive and may recur. After surgery, an accurate follow-up is warranted.
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Twenty-six patients with spinal cord tumor were studied by magnetic resonance imaging (MRI). Gadolinium-DTPA was used in seventeen of the 26 patients.MRI could not always differentiate extradural from intradural tumors. It was difficult to diagnose pathology of tumors by MRI. Gadolinium-DTPA was effective in depicting tumors clearly.
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Although the frequency of meningioma among primary spinal cord tumors is 25 %. multiple spinal cord meningiomas are extremely rare. Multiple spinal cord meningiomas have not been reported in the spinal cord meningioma series of A. Davis (45 patients), K.Katz (44 patients), Lombardi and Pasarini (71 patients). Haft and shenkin (367patients). (3.5.7.9) Walter ].Levy and his colleagues have reported two multiple spinal cord meningiomas among 97 patients who had spinal cord meningiomas.(8) F. Carta et al. have also reported two multiple spinal cord meningiomas.(2) Single cases of multiple spinal meningiomas have been described by Rand,Rath et al. and DiRocco et al. (4,9.10) Only Rath and his colleagues reported multiple meningiomas which were intradural thoracic and extradural cervical.(ll)
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✓ Intramedullary spinal cord schwannomas are rare benign tumors for which resection is possible and safe. The purpose of this paper is to present the magnetic resonance (MR) imaging features in two cases of intramedullary spinal cord schwannoma to assist both neurosurgeons and pathologists in preventing misdiagnosis and resultant partial resection. The MR imaging evidence of a small- or medium-sized well-marginated intramedullary spinal cord tumor in a patient in whom no syringomyelia is present but in whom moderate edema with marked Gd enhancement can be seen should be considered in the differential diagnosis of intramedullary spinal cord schwannoma. In cases in which an associated thickened Gd-enhancing spinal nerve root is seen the diagnosis of schwannoma should be assumed.
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We studied 17 cases of spinal cord tumors using magnetic resonance imaging. According to the intensity of image and histological feature of spinal cord tumors, we identified two groups in T2 weighted imaging. One was a hypointensity group showing cystic or vascular tumors, and the other was hyperintensity group of solid tumors. Preoperative images of swelling, narrowing, deviation of the spinal cord were remained after the operations. Grafted free fatty tissue for the prevention of adhesion was recognized well also after the operation. Postoperative imagings sometime showed pseudo-deviation of the spinal cord which was easy to be mistaken as the remains of tumors and narrowing of the spinal cord. In conclusions, The magnetic resonance imaging makes very early detection of spinal cord tumors possible, and it is valuable for a diagnosis of the spinal cord tumor associated with brain tumor.
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