MR imaging in spinal cord/ canal tumors

Introduction: A spinal tumor is an abnormal mass of tissue within or surrounding the spinal cord and spinal column, can cause significant morbidity and can be associated with mortality as well accounts for approximately 15% of cranio-spinal tumors. Aim: The present study was designed to determine the predictive value of Magnetic Resonance Imaging in diagnosing intra spinal tumors and to correlate findings on Magnetic Resonance Imaging with Pathological diagnosis. Materials and methods: This prospective study was conducted in Osmania General Hospital from 2009 to 2012 over a period of 3 years. The study group included 40 patients. In all patients, data on history, clinical examination and clinical diagnosis was obtained. MRI was performed on a 1.5 Tesla electromagnet (GE Company). The primary pulse sequences included T1 and T2W1 using spin echo and gradient echo techniques. The MR morphology was correlated with surgical and histopathological features. Results: The patients had age groups ranging from 2 years – 60 years with a mean age of 33 years. Twenty eight were males and twelve were females. The most commonly encountered symptoms were neurological deficit in 33, sensory loss in 25, bowel and bladder dysfunction in 20 and pain in 13 patients. Of the forty intra dural tumors, 28 were extra medullary and 12 were intra medullary present. Most of the tumors were located in the cervical and the dorsolumbar spine accounting for more than 50%. The most common tumor encountered in our study was schwannoma (22/40), followed by ependymoma (7/40), meningioma (4/40), astrocytoma (4/40), one each of Dermoid, arachnoid cyst and round cell tumor. The most commonly located in cervical, Cervicodorsal position (20), followed by lumbar (8), dorsolumbar (5), dorsal (5) and cervicolumbar (1), lumbosacral (1). MRI features of forty patients with intra dural tumors were studied and their signal intensities were correlated with the pathological findings. MRI diagnosis of intra dural tumors was correct in 34 of the 40 tumors. Contrast was useful for better delineation of the tumor and its characterization. However the different types of tumors could not be differentiated by their degree of contrast enhancement. Conclusion: Magnetic Resonance Imaging was found to be a highly sensitive imaging procedure and the method of choice for intra spinal tumors. Contrast was useful for better delineation of the tumor and its characterization.