MRI in the Evaluation Spinal Cord Tumors with Histopathological Correlation
Journal Title: Journal of Medical Science And clinical Research - Year 2018, Vol 6, Issue 6
Abstract
Spinal cord tumours are relatively slow growing tumours and can present with a wide variety of symptoms. If they are not diagnosed early and treated immediately they can lead to neurological deficits and disability. CT & MRI are the commonly used modalities for diagnosis of spinal tumours. The advent of Magnetic Resonance Imaging (MRI) has revolutionised the diagnosis and management of spinal cord tumours unless there is a contraindication. Objectives: To study the demographic profile and assess the distribution, features, localization, extent of spinal cord tumors by MRI and to correlate the tissue characterization by MRI with that of histopathological examination. Material & Methods: A prospective study was conducted on 87 patients who were diagnosed to have spinal cord tumor by Magnetic Resonance Imaging irrespective of age & sex from a period of October 2013 to October 2016.Those patients with spinal symptoms and pathology due to infection, prolapsed intervertebral disc and trauma were excluded from the study. All patients were followed up till surgery or biopsy for confirmatory histopathological diagnosis. The final diagnosis were correlated followed by analysis of the present study by comparing with previous similar studies from various literature. All the MRI scans of the spinal cord in this study were performed using GE Signa HDX MR machine with a 1.5 tesla field strength magnet. Pre contrast images were followed by post contrast images with intravenous administration of 0.1mmol/kg of body weight of Gadolinium. The standard imaging protocol used was T1,T2 sagittal, axial, coronal and T1 post contrast fat suppressed axial ,sagittal, coronal planes. Results: Out of 87 patients with spinal cord tumors, 47 patients (54%) were males and females made up around 46% (40 patients).The male and female ratio was 1.17:1. Around 5.7% of the patients were in the pediatric age group and the rest were adults. Our study showed that intradural extramedullary tumours 55/87(63%) were the commonest, followed by extradural tumours 17/87(19%) and intramedullary tumours 15/87(17%). Among intradural-extramedullary tumors Schwannoma was the commonest spinal cord tumor accounting for 57.4% of the tumors. Other tumors in decreasing order of frequency were meningiomas (22.%), neurofibromas (14.8%). Ependymomas was the commonest intramedullary tumors accounting for (61.5%) followed by hemangioblastoma (15.4%) & astrocytoma (7.6%). MRI proves to be best initial modality of imaging in evaluation of suspected tumours of the spine regardless of the space in which they may lie & morphologic characterization of the tumour in 93.1% of the spinal tumours. In the extradural space MRI is the most sensitive technique for the detection of tumours in the vertebral bodies.
Authors and Affiliations
Prof. Jayashree Mohanty,
Keywords
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