E5483. Intramedullary Spinal Tumors, Their Imaging Findings, and Mimics
Authors
Angela Kanna;
Tufts Medical Center
Neel Madan;
Brigham and Women's Hospital/_Massachusetts General Hospital
Background
Tumors within the spinal cord are relatively rare, and share general imaging characteristics, including expansion of the cord. There is a wide differential for abnormal signal and expansion of the cord, including primary or metastatic tumors, demyelinating disease, inflammatory and autoimmune processes, and vascular lesions.
Educational Goals / Teaching Points
- Differential diagnosis of intramedullary spinal lesions. - Classic imaging findings of intramedullary spinal tumors including astrocytoma, ependymoma, and hemangioblastoma, and less common tumors. - Imaging mimics of intramedullary spinal tumors, the importance of patient history, and discussion with the clinical team. - Example cases from our institution of intramedullary tumors and mimics.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Contrast-enhanced MRI of the spine is the best imaging modality to characterize intramedullary lesions of the spinal cord. Classic imaging appearance of ependymomas and astrocytomas primarily will be discussed, including location, extent of cord involvement, and the presence or absence of associated hemorrhage, cysts, and degree of edema. Additionally, less common neoplastic lesions will be described, as well as mimics of an autoimmune or vascular etiology.
Conclusion
Tumors within the spinal cord are relatively rare and share general imaging characteristics. As the imaging appearance of intramedullary tumors can be mimicked by multiple other diseases, history and clinical correlation are critical to arriving at the correct diagnosis.
