Spinal cord neoplasms and their mimics - 04/06/09
Résumé |
Objectifs |
Understand the pathologic-radiologic correlation of spinal cord ependymoma and astrocytoma regarding its location within the spinal cord and appearance.
Recognize common imaging manifestations of other spinal cord neoplasms.
Identify other imaging features that suggest other non-neoplastic spinal cord diseases.
Points clés |
Spinal cord ependymomas typically expand the spinal cord in a concentric fashion, are associated with polar cysts, and usually show intense enhancement with occasional hemorrhage.
Spinal cord astrocytomas are usually eccentric within the spinal cord, less well-defined compared to ependymomas, and show patchy enhancement.
Spinal cord ganglioglioma is often extensive and may not enhance.
Highly vascular neoplasms involving the spinal cord and filum terminale include hemangioblastoma and paraganglioma.
Spinal cord metastasis is very rare and characteristically has extensive edema in patients who usually have more motor weakness rather than sensory deficits.
Résumé |
Intramedullary spinal cord neoplasms are rare, accounting for about 4 %-10 % of all central nervous system tumors. Despite their rarity, these lesions are important to the radiologist because magnetic resonance (MR) imaging is the preoperative study of choice to narrow the differential diagnosis and guide surgical resection. Ependymoma and astrocytoma constitute up to 70 % of all intramedullary spinal cord neoplasms. Spinal cord ependymoma is the most common type of spinal cord neoplasms in adults. Since it arises from the ependymal lining of the central canal, the tumor typically has a concentric expansion of the spinal cord and is often associated with peripheral hemorrhage (« cap sign »), most conspicuous on sagittal T2-weighted MR images. Spinal cord astrocytoma is most common in children although the peak age is during the 3rd and 4th decades. Most spinal cord astrocytomas are regarded as WHO grade I or II tumors. The tumor is usually eccentric in location within the spinal cord, is not usually associated with tumoral cysts, and is characterized by patchy often ill-defined enhancement. The other tumors are less common and will be detailed in the course : myxopapillary ependymoma, ganglioglioma, hemangioblastoma, paraganglioma, and spinal cord Numerous diseases mimic spinal cord neoplasms but are often be differentiated by clinical means or cerebrospinal f1uid analysis.
Le texte complet de cet article est disponible en PDF.Mots clés : Moelle épinière, tumeur
Vol 89 - N° 10
P. 1310 - octobre 2008 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.