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MR imaging features that distinguish spinal cavernous angioma from hemorrhagic ependymoma and serial MRI changes in cavernous angioma

 Inhwan Jeon  ;  Woo Sang Jung  ;  Sang Hyun Suh  ;  Tae-Sub Chung  ;  Yong-Eun Cho  ;  Sung Jun Ahn 
 JOURNAL OF NEURO-ONCOLOGY, Vol.130(1) : 229-236, 2016 
Journal Title
Issue Date
Adult ; Aged ; Diagnosis, Differential ; Ependymoma/diagnostic imaging* ; Ependymoma/etiology* ; Female ; Follow-Up Studies ; Hemangioma, Cavernous/complications* ; Hemangioma, Cavernous/therapy* ; Hemorrhagic Disorders/complications* ; Humans ; Image Processing, Computer-Assisted ; Magnetic Resonance Imaging* ; Male ; Middle Aged ; Retrospective Studies ; Spinal Cord Neoplasms/diagnosis* ; Spinal Cord Neoplasms/etiology*
Cavernous angioma ; Ependymoma ; Hemorrhage ; Spinal cord
Cavernous angiomas of the spinal cord exhibit imaging characteristics that may overlap with those of hemorrhagic ependymoma. In the present study, we aimed to identify specific magnetic resonance imaging (MRI) findings that could be used to differentiate cavernous angioma from hemorrhagic ependymoma, and to evaluate serial MRI changes in cases of cavernous angioma. We retrospectively evaluated MR images of spinal cord tumors collected at our hospital from 2007 to 2015. From this cohort of images, 11 pathologically confirmed cavernous angiomas and 14 pathologically confirmed hemorrhagic ependymomas were compared with respect to the size of the tumor, longitudinal location, axial location, enhancement pattern, syrinx, edema, tumor margin, signal intensity of T2WI, signal intensity of T1WI, and longitudinal spreading of the hemorrhage. Serial MR images of seven spinal cavernous angiomas were reviewed. Small size, eccentric axial location, minimal enhancement, and absence of edema were more frequently observed on images of cavernous angioma compared to those of hemorrhagic ependymoma (p?<?0.01). Serial MRI changes in cases of cavernous angioma included increased longitudinal spreading of the hemorrhage (6/7, 86?%) and emergence of high signal intensity on T1WI (1/7, 14?%). Small size, eccentric axial location, minimal enhancement, and absence of edema are significant MRI findings that may be used to distinguish Type I and Type II spinal cavernous angiomas from hemorrhagic ependymomas. Furthermore, longitudinal spreading of the hemorrhage may be observed on follow-up MRIs of cavernous angiomas.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Suh, Sang Hyun(서상현) ORCID logo https://orcid.org/0000-0002-7098-4901
Ahn, Sung Jun(안성준) ORCID logo https://orcid.org/0000-0003-0075-2432
Jeon, In Hwan(전인환)
Jung, Woo Sang(정우상)
Chung, Tae Sub(정태섭)
Cho, Yong Eun(조용은) ORCID logo https://orcid.org/0000-0001-9815-2720
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