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MRI spectrum of intrinsic spinal cord lesions
ABSTRACTS
APRIL-TUNE 1992
diffuse infiltration of midline adjacent brain structures including medulla. Areas with focal anaplasia occasionally reveal an accumulation of contrast media. The diffuse tumor manifestation requires a differentiation from encephalitis and demyelinating diseases with a similar distribution pattern of lesions. Three cases have been examined. In conclusion the performance of MRI including control and brain biopsy are indicated to establish an in vivo diagnosis. Authors’ Summary
MRI ENHANCEMENT OF THE INTERVERTEBRAL DISC AFTER INJECTION OF CONTRAST MEDIUM (In French)
Cosnard G, Cordoliani YS, Pharaboz C, et al. (Service de Radiologie, HIA Val-de-Grace 74, Boulevard de Port-Royal, F-75320 Paris Cedex, France]. J Radio1 1991;72:563-574. From January 1989 to March 1991,478 examinations of the lumbar spine were performed by magnetic resonance imaging (MRI) in 400 individuals complaining of recurrent pain after surgery for herniation of a lumbar disc. The examinations were performed in the axial and sagittal planes, before and after injection of contrast agent. Eighty-three patients were operated on for the second time with satisfactory results. In 70 patients a recurrence of the disc herniation or an incomplete removal of the herniated disc was found. In 25 of 70 patients, the findings detected by MRI could be compared with the anatomo-pathological findings following surgery. The delay between the first surgical intervention and the second ranged from 3 days to 7 years. In only one case was there no enhancement. Enhancement of the venous plexus was observed in 5 of 24 cases, an inflammatory or granulomatous process in 12 of 24,a degenerated disc with fibrosis in 5 of 24, and significant osteophytes in 2 of 24. Numerous and clear illustrations accompany the article. Antonio
F. Govoni. MD
MRI SPECTRUM OF INTRINSIC LESIONS
SPINAL CORD
Low V, Khangure MS. (Radiology Department, Sir Charles Gairdner Hospital, The Queen Elizabeth Hospital Medical Centre, Verdun Street, Nedlands WA 6009, Australia). Australas Radio1 1991;35:212-219.
139
We report our experience of 42 patients undergoing magnetic resonance imaging (MRI) studies demonstrating intrinsic lesions of the spinal cord, excluding those secondary to spondylosis, trauma, or congenital malformations. Histological confirmation of the radiological diagnosis was obtained in 15 (36%).MRI is more sensitive than either myelography or computed tomography (CT). MRI identified a previously nonvisualised lesion in 17 of 30 cases. In a further 13 cases, MRI contributed by identifying associated features such as cysts and hemorrhage, which have aided in the diagnosis and management of the patients. The last 12 cases, which were patients with multiple sclerosis, had MRI as the only neuroradiological examination. These illustrate a range of appearances. The overlap of imaging appearances of the various pathologies implies that a useful diagnosis and differential can only be offered by considering the MRI appearances of a lesion, with its associated features, with the clinical presentation, and with other imaging modalities where appropriate. Authors’ Summary
MRI OF LUMBAR AND SACRAL PLEXUS NERVE SHEATH TUMORS
Breidahl WH, Khangure MS. (M.S.K.: Department of Radiology-MRI, Queen Elizabeth II Medical Centre, Verdun Street, Nedlands 6009, Western Australia). Australas Radio1 1991;35:140-144. Seven patients with peripheral nerve sheath tumors affecting the lumbo-sacral plexus were examined with magnetic resonance imaging (MRI) utilizing a 1.5 T magnet and spin-echo pulse sequences. The majority of tumors were homogeneous in signal intensity and isointense with adjacent muscle on T-l weighted images and showed markedly increased signal intensity on T2-weighted images with central areas of relatively low signal intensity. An attempt to obtain a pathological correlation with the areas of low signal on T-2 weighted images was unsuccessful. The use of Gadolinium-DTPA in one patient resulted in irregular enhancement of both a neurogenic sarcoma and smaller neurofibromas. The multiplanar imaging capabilities, high soft-tissue contrast, noninvasiveness, lack of ionizing radiation and the characteristic appearance of neural tumors makes MR ideal for imaging these lesions. Authors’ Summary
APRIL-TUNE 1992
diffuse infiltration of midline adjacent brain structures including medulla. Areas with focal anaplasia occasionally reveal an accumulation of contrast media. The diffuse tumor manifestation requires a differentiation from encephalitis and demyelinating diseases with a similar distribution pattern of lesions. Three cases have been examined. In conclusion the performance of MRI including control and brain biopsy are indicated to establish an in vivo diagnosis. Authors’ Summary
MRI ENHANCEMENT OF THE INTERVERTEBRAL DISC AFTER INJECTION OF CONTRAST MEDIUM (In French)
Cosnard G, Cordoliani YS, Pharaboz C, et al. (Service de Radiologie, HIA Val-de-Grace 74, Boulevard de Port-Royal, F-75320 Paris Cedex, France]. J Radio1 1991;72:563-574. From January 1989 to March 1991,478 examinations of the lumbar spine were performed by magnetic resonance imaging (MRI) in 400 individuals complaining of recurrent pain after surgery for herniation of a lumbar disc. The examinations were performed in the axial and sagittal planes, before and after injection of contrast agent. Eighty-three patients were operated on for the second time with satisfactory results. In 70 patients a recurrence of the disc herniation or an incomplete removal of the herniated disc was found. In 25 of 70 patients, the findings detected by MRI could be compared with the anatomo-pathological findings following surgery. The delay between the first surgical intervention and the second ranged from 3 days to 7 years. In only one case was there no enhancement. Enhancement of the venous plexus was observed in 5 of 24 cases, an inflammatory or granulomatous process in 12 of 24,a degenerated disc with fibrosis in 5 of 24, and significant osteophytes in 2 of 24. Numerous and clear illustrations accompany the article. Antonio
F. Govoni. MD
MRI SPECTRUM OF INTRINSIC LESIONS
SPINAL CORD
Low V, Khangure MS. (Radiology Department, Sir Charles Gairdner Hospital, The Queen Elizabeth Hospital Medical Centre, Verdun Street, Nedlands WA 6009, Australia). Australas Radio1 1991;35:212-219.
139
We report our experience of 42 patients undergoing magnetic resonance imaging (MRI) studies demonstrating intrinsic lesions of the spinal cord, excluding those secondary to spondylosis, trauma, or congenital malformations. Histological confirmation of the radiological diagnosis was obtained in 15 (36%).MRI is more sensitive than either myelography or computed tomography (CT). MRI identified a previously nonvisualised lesion in 17 of 30 cases. In a further 13 cases, MRI contributed by identifying associated features such as cysts and hemorrhage, which have aided in the diagnosis and management of the patients. The last 12 cases, which were patients with multiple sclerosis, had MRI as the only neuroradiological examination. These illustrate a range of appearances. The overlap of imaging appearances of the various pathologies implies that a useful diagnosis and differential can only be offered by considering the MRI appearances of a lesion, with its associated features, with the clinical presentation, and with other imaging modalities where appropriate. Authors’ Summary
MRI OF LUMBAR AND SACRAL PLEXUS NERVE SHEATH TUMORS
Breidahl WH, Khangure MS. (M.S.K.: Department of Radiology-MRI, Queen Elizabeth II Medical Centre, Verdun Street, Nedlands 6009, Western Australia). Australas Radio1 1991;35:140-144. Seven patients with peripheral nerve sheath tumors affecting the lumbo-sacral plexus were examined with magnetic resonance imaging (MRI) utilizing a 1.5 T magnet and spin-echo pulse sequences. The majority of tumors were homogeneous in signal intensity and isointense with adjacent muscle on T-l weighted images and showed markedly increased signal intensity on T2-weighted images with central areas of relatively low signal intensity. An attempt to obtain a pathological correlation with the areas of low signal on T-2 weighted images was unsuccessful. The use of Gadolinium-DTPA in one patient resulted in irregular enhancement of both a neurogenic sarcoma and smaller neurofibromas. The multiplanar imaging capabilities, high soft-tissue contrast, noninvasiveness, lack of ionizing radiation and the characteristic appearance of neural tumors makes MR ideal for imaging these lesions. Authors’ Summary