Abstract
This study evaluates the effectiveness of CT and MR imaging in differentiating intradural extramedullary spinal schwannomas and meningiomas in a large group of patients. In addition, the study correlates tumour location, morphologic characteristics and enhancement pattern. From January 2000 to June 2007, we retrospectively reviewed 128 consecutive patients (51 male, 77 female; mean age at admission 53.8 years; range 17–83 years) with spinal intradural extramedullary tumours (92 schwannomas, 36 meningiomas) at our institution. Fifty-one of ninety-two schwannomas (55.4%) showed fluid signal intensity on T2-weighted MR images. Twenty-two of thirty-six meningiomas (61.1%) showed hyperintense signal intensity and thirteen of thirty-six meningiomas (36.1%) showed isointense signal on T2-weighted MR images. Fifty-four schwannomas (58.7%) showed rim enhancement and thirty-three meningiomas (91.7%) showed diffuse enhancement on contrast-enhanced T1-weighted MR imaging. Twenty-one meningiomas (58.3%) showed dural tail sign in contrast-enhanced T1-weighted MR imaging. Twenty-one meningiomas (58.3%) showed calcification on CT images. MR and CT imaging results are therefore useful for the differentiation of schwannomas from meningiomas of the spine.
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Abul-Kasim K, Thurnher MM, McKeever P, Sundgren PC (2008) Intradural spinal tumors: current classification and MRI features. Neuroradiology 50:301–314
Schroth G, Thron A, Guhl L, Voigt K, Niendorf HP, Garces LR (1987) Magnetic resonance imaging of spinal meningiomas and neurinomas. Improvement of imaging by paramagnetic contrast enhancement. J Neurosurg 66:695–700
Matsumoto S, Hasuo K, Uchino A, Mizushima A, Furukawa T, Matsuura Y, Fukui M, Masuda K (1993) MRI of intradural-extramedullary spinal neurinomas and meningiomas. Clinical Imaging 17:46–52
Alorainy IA (2006) Dural tail sign in spinal meningiomas. Eur J Radiol 60:387–391
Levy WJ, Latchaw J, Hahn JF, Sawhny B, Bay J, Dohn DF (1986) Spinal neurofibromas: a report of 66 cases and a comparison with meningiomas. Neurosurgery 18:331–334
Boisserie-Lacroix M, Kien P, Caille JM (1987) Imaging of intradural extramedullary tumours: neurinomas and meningiomas. J Neuroradiol 14:66–81
Albanese V, Platania N (2002) Spinal intradural extramedullary tumours. Personal experience. J Neurosurg Sci 46:18–24
Friedman DP, Tartaglino LM, Flanders AE (1992) Intradural schwannomas of the spine: MR findings with emphasis on contrast-enhancement characteristics. AJR Am J Roentgenol 158:1347–1350
Demachi H, Takashima T, Kadoya M, Suzuki M, Konishi H, Tomita K, Yonezawa K, Ubukata A (1990) MR imaging of spinal neurinomas with pathological correlation. J Comput Assist Tomogr 14:250–254
King AT, Sharr MM, Gullan RW, Bartlett JR (1998) Spinal meningiomas: a 20-year review. Br J Neurosurg 12:521–526
Klekamp J, Samii M (1999) Surgical results for spinal meningiomas. Surg Neurol 52:552–562
Solero CL, Fornari M, Giombini S, Lasio G, Oliveri G, Cimino C, Pluchino F (1989) Spinal meningiomas: review of 174 operated cases. Neurosurgery 25:153–160
Seppala MT, Haltia MJ, Sankila RJ, Jaaskelainen JE, Heiskanen O (1995) Long-term outcome after removal of spinal schwannoma: a clinicopathological study of 187 cases. J Neurosurg 83:631–626
Roux FX, Nataf F, Pinaudeau M, Borne G, Devaux G, Meder JF (1996) Intraspinal meningiomas: review of 54 cases with discussion of poor prognosis factors and modern therapeutic management. Surg Neurol 46:458–463 discussion 463–454
De Verdelhan O, Haegelen C, Carsin-Nicol B, Riffaud L, Amlashi SF, Brassier G, Carsin M, Morandi X (2005) MR imaging features of spinal schwannomas and meningiomas. J Neroradiol 32:42–49
Bull JW (1953) Spinal meningiomas and neurofibromas. Acta radiol 40:283–300
Obsborn AG (1994) Diagnostic radiology. Mosby, St Louis
Quekel LG, Versteege CW (1995) The “dural tail sign” in MRI of spinal meningiomas. J Comput Assist Tomogr 19:890–892
Li MH, Hltås S, Lasson EM (1992) MR imaging of intradural extramedullary tumours. Acta Radiol 33:207–212
Watabe T, Azuma T (1989) T1 and T2 measurements of meningiomas and neuromas before and after Gd-DTPA. AJNR Am J Neuroradiol 10:463–470
Gebauer GP, Farjoodi P, Sciubba DM, Gokaslan ZL, Rilley LH 3rd, Wasserman BA, Khanna AJ (2008) Magnetic resonance imaging of spinal tumours: classification, differential diagnosis, and spectrum of disease. J Bone Jnt Surg Am 90:146–162
Sze G (1988) Gadolinium-DTPA in spinal disease. Radiol Cln North Am 26:1009–1024
Varma DG, Moulopoulos A, Sara AS (1992) MR imaging of extracranial nerve sheath tumours. J Comput Assist Tomogr 16:448–453
Tien RD, Yang PJ, Chu PK (1991) “Dural tail sign”: a specific MR sign for meningioma? J Comput Assist Tomogr 15:64–66
Goldsher D, Litt AW, Pinto RS, Bannon KR, Kricheff II (1990) Dural “tail” associated with meningiomas on Gd-DTPA-enhanced MR images: characteristics, differential diagnostic value, and possible implications for treatment. Radiology 176:447–450
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We are grateful to Mi Sun Kim and Jin-Hee Kim for the editorial and statistical assistance.
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Liu, W.C., Choi, G., Lee, SH. et al. Radiological findings of spinal schwannomas and meningiomas: focus on discrimination of two disease entities. Eur Radiol 19, 2707–2715 (2009). https://doi.org/10.1007/s00330-009-1466-7
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DOI: https://doi.org/10.1007/s00330-009-1466-7