Abstract
Study design:
Retrospective chart review.
Objectives:
Each type of intramedullary spinal cord tumor (IMSCT) has specific anatomical and pathological features visible on magnetic resonance (MR) imaging. The purpose of this study was to investigate the accuracy of preoperative IMSCT diagnosis using our diagnostic chart of tumor-specific MR imaging findings.
Setting:
Hamamatsu, Japan.
Methods:
From 2009 to 2013, 28 consecutive patients with IMSCT who underwent surgery in our university hospital were included in this study. There were 17 men and 11 women with an average age of 49 years (12–81). The pathological diagnoses were hemangioblastoma (12), ependymoma (11), astrocytoma (4) and squamous cell carcinoma (1). Tumor-specific MR imaging findings were as follows: ependymoma ((a) spinal cord swelling, (b) contrast effect with necrosis, (c) tumor in the center of the spinal cord), hemangioblastoma ((a) spinal cord swelling, (b) homogeneous contrast effect) and astrocytoma ((a) spinal cord swelling, (b) contrast effect is either, (c) eccentric tumor). Based on these features, we generated a diagnostic chart to investigate the MR imaging diagnosis accuracy for IMSCTs.
Results:
The accuracy of preoperative diagnosis was 89% (25/28 cases). Correct diagnoses were made in 100% of hemangioblastomas (12/12 cases), 90% of ependymomas (9/11 cases) and 100% of astrocytomas (4/4 cases).
Conclusions:
Different types of IMSCTs exhibit unique MR imaging characteristics. These features can be used to preoperatively diagnose IMSCTs with high accuracy.
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References
Brotchi J . Intrinsic spinal cord tumor resection. Neurosurgery 2002; 50: 1059–1063.
Constantini S, Miller DC, Allen JC, Rorke LB, Freed D, Epstein FJ . Radical excision of intramedullary spinal cord tumors: surgical morbidity and long-term follow-up evaluation in 164 children and young adults. J Neurosurg 2000; 93: 183–193.
Kzane PJ, el-Mahdy W, Singh A, Powell MP, Crockard HA . Spinal intradural tumours: Part II–Intramedullary. Br J Neurosurg 1999; 13: 558–563.
Shrivastava RK, Epstein FJ, Perin NI, Post KD, Jallo GI . Intramedullary spinal cord tumors in patients older than 50 years of age: management and outcome analysis. J Neurosurg Spine 2005; 2: 249–255.
Manzano G, Green BA, Vanni S, Levi AD . Contemporary management of adult intramedullary spinal tumors-pathology and neurological outcomes related to surgical resection. Spinal Cord 2008; 46: 540–546.
Regelsberger J, Fritzsche E, Langer N, Westphal M . Intraoperative sonography of intra- and extramedullary tumors. Ultrasound Med Biol 2005; 31: 593–598.
Do-Dai DD, Brooks MK, Goldkamp A, Erbay S, Bhadelia RA . Magnetic resonance imaging of intramedullary spinal cord lesions: a pictorial review. Curr Probl Diagn Radiol 2010; 39: 160–185.
Goy AM, Pinto RS, Raghavendra BN, Epstein FJ, Kricheff II . Intramedullary spinal cord tumors: MR imaging, with emphasis on associated cysts. Radiology 1986; 161: 381–386.
Koeller KK, Rosenblum RS, Morrison AL . Neoplasms of the spinal cord and filum terminale: radiologic-pathologic correlation. Radiographics 2000; 20: 1721–1749.
Sandalcioglu IE, Gasser T, Asgari S, Lazorisak A, Engelhorn T, Egelhof T et al. Functional outcome after surgical treatment of intramedullary spinal cord tumors: experience with 78 patients. Spinal Cord 2005; 43: 34–41.
van Velthoven V . Intraoperative ultrasound imaging: comparison of pathomorphological findings in US versus CT, MRI and intraoperative findings. Acta Neurochir Suppl 2003; 85: 95–99.
McCormick PC, Torres R, Post KD, Stein BM . Intramedullary ependymoma of the spinal cord. J Neurosurg 1990; 72: 523–532.
Klekamp J . Treatment of intramedullary tumors: analysis of surgical morbidity and long-term results. J Neurosurg Spine 2013; 19: 12–26.
Raco A, Esposito V, Lenzi J, Piccirilli M, Delfini R, Cantore G . Long-term follow-up of intramedullary spinal cord tumors: a series of 202 cases. Neurosurgery 2005; 56: 972–981.
Epstein FJ, Farmer JP, Freed D . Adult intramedullary spinal cord ependymomas: the result of surgery in 38 patients. J Neurosurg 1993; 79: 204–209.
Miller DC . Surgical pathology of intramedullary spinal cord neoplasms. J Neurooncol 2000; 47: 189–194.
Fischer G, Brotchi J . Intramedullary Spinal Cord Tumors. Thieme: Stuttgart. 1996.
Ozawa H, Sato T, Kokubun S . Differential diagnosis of intramedullary spinal cord tumors by MRI. Orthop Surg Traumatol 2001; 44: 273–278.
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Arima, H., Hasegawa, T., Togawa, D. et al. Feasibility of a novel diagnostic chart of intramedullary spinal cord tumors in magnetic resonance imaging. Spinal Cord 52, 769–773 (2014). https://doi.org/10.1038/sc.2014.127
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DOI: https://doi.org/10.1038/sc.2014.127
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