Magnetic Resonance Imaging Features of Intramedullary Spinal Cord Tumors with Pathological Correlations

Objective: The purpose of this study was to determine characteristic imaging findings of intramedullary spinal cord tumor in magnetic resonance imaging (MRI). Material and Methods: We retrospectively analyzed MRI in 15 patients with histologicaly proven intramedullary spinal cord tumors. The demographic data, MRI findings with histological findings were recorded in terms of age, location, length, morphology, signal intensity, the presence or absence of cyst and hemorrhage, enhancement pattern, other associated findings, necrosis, vascular proliferation and WHO grading. Results: Among the 15 patients, spinal cord ependymomas were eccentric 75%, well-define border 62.5% and cervicothoracic spine located 37.5%. Spinal cord astrocytomas were eccentrically located and ill-define border 85.7%, cervicothoracic and thoracic spine located 28.5%. A cystic component was seen in 87.5% of spinal cord ependymoma and 71.5% of astrocytomas. Intratumoral hemorrhage occurred in 75% of spinal cord ependymomas, and 57.1% of astrocytomas. In 12.5% of spinal cord ependymomas, a curvilinear low T2 signal, suggesting marginal hemorrhage, was seen at the upper and/or lower margins of the tumors. Twenty-five percent of spinal cord ependymoma and 57.2% of astrocytomas showed heterogeneous enhancement, while in 12.5% of spinal cord ependymomas, enhancement was homogeneous. Conclusion: Although no statistically significant characteristic MRI feature to distinguish between ependymoma and astrocytoma is detected. By percentage we found that border, length and signal intensity of tumors may help diagnosis. With pathological correlation, all of spinal cord ependymomas are mark hypervascular tumor, but astrocytomas never showed.