Diverse Characteristics of Spinal Nerve Sheath Tumor on Magnetic Resonance Images / 대한척추외과학회지

STUDY DESIGN: A restrosepctive study OBJECTIVES: We present the diverse imaging features of a spinal nerve sheath tumor for the preoperative diagnosis and treatment. SUMMARY OF LITERATURE REVIEW: The typical imaging findings of spinal nerve sheath tumors are reported in the literature. However, they can show diverse and unusual imaging features. MATERIALS AND METHODS: The study group consisted of 30 patients who had undergone MR imaging for a preoperative evaluation of a spinal nerve sheath tumor from September 1989 to February 2008. All patients had undergone surgery for a spinal tumor that was confirmed by biopsy. The mean follow-up period was 13.1 months. The T1-, T2-weighted spine echo images and contrast material images were obtained in the sagittal plane. Axial images were obtained in any area of the spine where the sagittal images demonstrated abnormal findings. The signal intensity of the lesion, homogenicity, heterogenicity were evaluated in the T1-, T2-, and enhanced images RESULTS: Twenty-four cases were neurilemmoma and 6 cases were neurofibromas. Different types of neurilemmomas included neurilemmomas with cystic changes (n=6), focal hemorrhage (n=5), extensive vertebral destruction (n=1), and giant neurilemmoma(n=1). The T1-weighted image showed low and intermediate signal intensity. The T2-weighted image showed high-signal intensity except for one neurilemmoma. The Gd-DTPA enhanced image showed homogenous, heterogeneous, and rim enhancement except for one case of a neurilemmoma with cystic changes. CONCLUSIONS: Spinal nerve sheath tumors can show diverse and unusual imaging findings. An awareness of the uncommon presentations of these tumors is important for making a preoperative diagnosis and treatment. MRI is valuable in characterizing the soft tissue and bony anatomy in spinal neurilemmoma and neurofibroma.

Characterization of Magnetic Resonance Images for Spinal Cord Tumors

STUDY DESIGN: Retrospective study MR images for spinal cord tumors. PURPOSE: To analyze the characteristics of MR images for spinal cord tumors, which were then verified at surgery or biopsy. OVERVIEW OF LITERATURE: MR images are often used as the primary diagnostic imaging tool and the preoperative study of choice. The need for biopsy may be obviated because of increasingly accurate preoperative histologic diagnosis by MR images. METHODS: The study group consisted of 39 patients who had undergone MR imaging for preoperative evaluation of spinal cord tumors between September 1989 and February 2008. All patients had operations for spinal cord tumors, which were confirmed at biopsy. Of the 39 patients, 18 were men, and 21 were women. The average follow-up period was 23.8 months. The mean patient age was 46.6 years. RESULTS: Diagnoses included neurilemmoma (19 cases), neurofibroma (4 cases), meningioma (5 cases), hemangioma (3 cases), giant cell tumor (1 case), ganglioneuroma (1 case), lymphoma (1 case), neuroblastoma (1 case), and metastatic tumor from the prostate (1 case). The remaining 3 cases were composed of arachnoid cysts (2 cases) and a vascular malformation (arteriovenous malformation, 1 case). CONCLUSIONS: MR images are the preoperative modality of choice in the evaluation of spinal cord tumors. MR images can narrow the differential diagnosis and guide surgical resection.