MRI diagnosis and differentiation of the spinal cord hemangioblastomas

Objective:To analyse the MRI features and differentiation of the spinal cord hemangioblastomas.Methods:The plain and post-contrast MRI of 11 patients with spinal cord hemangioblastomas were analyzed restrospectively.The MRI features and the difference of the MRI features between the patients with VHL syndrome and without VHL syndrome were explored.Results:A total of 27 tumors were found in the 11 patients,8 patients had solitary tumor(72.7%),3 patients with VHL syndrome had multiple tumors.The MR features depended on the size of tumor.Except for small(≤1 cm) hemangioblastomas which were located in the cervical spinal cord,most hemangioblastomas were located in the thoracic spinal cord,frequently along its posterior aspect.Hemangioblastomas showed well-demarcated,intense enhancement.Small(≤1 cm) hemangioblastomas were dotted or nodular shape,showed iso-T1 and slightly long T2 signal intensity and homogeneous enhancement.Large(1 cm) hemangioblastomas tended to be sausage,gourd or irregular shape,showed mixed slightly long T1 and slightly short T2 signal intensity and heterogeneous enhancement.Hemangioblastomas were accompanied with extensive spinal code cystic change and edema frequently,which were not correlated with the size of the hemangioblastoma.Large(1 cm) tumors invariably had vascular flow voids in or around the tumor(100%).There was no difference in the MR findings between the two patient groups,except for the multiplicity and higher percentage of small tumors in patients with VHL syndrome.Conclusion:The MR findings of spinal cord hemangioblastomas are characteristic.MRI is the optimal modality.