Radiological Verses Histological Evaluation of Spinal Space Occupying Lesions
DOI:
https://doi.org/10.36552/pjns.v27i4.876Abstract
Objective: This study set out to evaluate radiology's diagnostic capacity in accurately establishing a preliminary working diagnosis for various spine tumor types.
Materials and Methods: This is a prospective study carried out and examined patients who had surgical resection with the collection of histopathology samples, regardless of age or gender. A full MRI examination from every angle and contrast-enhanced pictures were required. Inclusion criteria consisted of Patients of all ages of both genders, who underwent surgery a tissue sample was collected for histopathological diagnoses, and a complete MRI study with all views and contrast-enhanced images was available to give a preliminary diagnosis.
Results: Based on the evaluation by the senior radiologists, the lesions were most commonly intradural-extramedullary (50%) in position according to the dura, followed by intramedullary in 14 (26.9%) patients. Despite our series having a total of 16 misdiagnosed cases, the overall diagnostic accuracy of the MRI remained high at 69.2%.
Conclusion: MRI has superior diagnostic accuracy in diagnosing meningiomas as compared to nerve sheath tumors such as meningiomas. It also has good predictive accuracy of intramedullary lesions such as ependymomas.
References
Lewandrowski KU, Anderson ME, McLain RF. Tumors of the Spine. In: Herkowitz HN, Garfin SR, Eismont FJ, Bell GR, Balderston RA, et al., editors. Philadelphia: Elsevier Saunders; 2011: pp. 1480–1512.
Jeon JH, Hwang HS, Jeong JH, Park SH, Moon JG, Kim CH. Spinal schwannoma; analysis of 40 cases. Journal of Korean Neurosurgical Society. 2008;43(3):135.
Jellema K, Van Overbeeke JJ, Teepen HL, Visser LH. Time to diagnosis of intraspinal tumors. European journal of neurology. 2005;12(8):621-4.
Ruggeri AG, Fazzolari B, Colistra D, Cappelletti M, Marotta N, Delfini R. Calcified spinal meningiomas. World Neurosurg. 2017;102:406–412.
Westwick HJ, Shamji MF. Effects of sex on the incidence and prognosis of spinal meningiomas: a Surveillance, Epidemiology, and End Results study. J Neurosurg Spine 2015;23(3):368–373.
Koeller KK, Shih RY. Intradural extramedullary spinal neoplasms: radiologic-pathologic correlation. Radiographics. 2019;39(2):468-90.
Azad TD, Jiang B, Bettegowda C. Molecular foundations of primary spinal tumors-implications for surgical management. Ann Transl Med. 2019;7(10):222.
Davies AM, Cassar-Pullicino VN. Principles of detection and diagnosis. Imaging of Bone Tumors and Tumor-Like Lesions: Techniques and Applications. 2009:111-37.
Asilturk M, Abdallah A, Sofuoglu E. Radiologic–Histopathologic correlation of adult spinal tumors: A retrospective study. Asian Journal of Neurosurgery. 2020;15(02):354-62.
Weber C, Gulati S, Jakola AS, Habiba S, Nygaard ØP, Johannesen TB, Solheim O. Incidence rates and surgery of primary intraspinal tumors in the era of modern neuroimaging: a national population-based study. Spine. 2014;39(16):E967-73.
Duong LM, McCarthy BJ, McLendon RE, Dolecek TA, Kruchko C, Douglas LL, Ajani UA. Descriptive epidemiology of malignant and nonmalignant primary spinal cord, spinal meninges, and cauda equina tumors, United States, 2004?2007. Cancer. 2012;118(17):4220-7.
Solero CL, Fornari M, Giombini S, Lasio G, Oliveri G, Cimino C, Pluchino F. Spinal meningiomas: review of 174 operated cases. Neurosurgery. 1989;25(2):153-60.
Soderlund KA, Smith AB, Rushing EJ, Smirniotopolous JG. Radiologic-pathologic correlation of pediatric and adolescent spinal neoplasms: Part 2, intradural extramedullary spinal neoplasms. AJR Am J Roentgenol. 2012;198:44-51.
Setzer M, Vatter H, Marquardt G, Seifert V, Vrionis FD. Management of spinal meningiomas: Surgical results and a review of the literature. Neurosurg Focus. 2007;23:E14.
Vold?ich R, Netuka D, Beneš V. Spinal meningiomas: is Simpson grade II resection radical enough? Acta neurochirurgica. 2020;162:1401-8.
Birch BD, McCormick PC, Resnick DK. Intradural extramedullary spinal lesions. InSpine Surgery 2005; (pp. 948-960). Churchill Livingstone.
De Verdelhan O, Haegelen C, Carsin-Nicol B, et al. MR imaging features of spinal schwannomas and meningiomas. J Neuroradiol. 2005;32(1):42–49.
Alorainy IA. Dural tail sign in spinal meningiomas. EurJ Radiol. 2006;60(3):387–391.
Goldsher D, Litt AW, Pinto RS, Bannon KR, Kricheff II. Dural “tail” associated with meningiomas on Gd-DTPA enhanced MR images: characteristics, differential diagnostic value, and possible implications for treatment. Radiol. 1990;176(2):447–450.
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