Magnetic resonance diffusion tensor imaging in differentiation of spinal cord intramedullary tumors and tumor mimics

Congress:

ECR 2020

Poster Number:

C-04084

Type:

Scientific Exhibit

Keywords:

Cross-sectional study, Prospective, Neoplasia, Diagnostic procedure, MR-Functional imaging, MR-Diffusion/Perfusion, MR, Oncology, Neuroradiology spine, CNS, Neuro, Performed at one institution

Authors:

D. K. M. Khedr, M. tantawy, M. Settein, G. el hawary; Mansoura/EG

DOI:

10.26044/ecr2020/C-04084

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-04084

Fig. 1: A case of demyelination A) Axial T2 WI showing focal area of abnormal signal...

Fig. 2: A case of astrocytoma. A) Axial T2 WI showing focal area of abnormal signal...

Fig. 6: ROC curve of DTI metrics for prediction of tumor lesion compared to...

Table 1: ROC curve for prediction of tumor lesion compared to inflammation including...

Purpose

one of the most important differential diagnosis for intramedullary spinal cord tumors are the inflammatory processes. Despite, the specific radiological appearance of each disease category. The conventional routine MRI as well as the clinical symptoms fail to the distinction among these pathologic entities and considered to be a big diagnostic dilemma. The final diagnosis is reached by surgical biopsy for indeterminate lesions (1-3). Diffusion tensor imaging (DTI) is an advanced noninvasive technique used in brain white matter assessment and can be applied to the spinal...

Methods and materials

Study population: This prospective study included 42 patients (24 males and 18 females): 16 cases with intramedullary spinal cord tumors and 26 cases with tumor mimics (Spinal cord inflammation/ demyelination) disorders in the period from January 2017 to January 2018 in Mansoura university hospitals. The inclusion criteria were cases of intramedullary tumors based on pathological bases, MRI examination (Conventional and post-contrast); good general condition of the patient and absence of exogenous implants. Exclusion criteria were: previous spinal surgery or fixation. Data acquisition: All MRI examinations...

Results

Conventional MRI evaluation: The inflammatory cases included: 13 cases of multiple sclerosis, 12 cases of transverse myelitis and one case of neuromyelitis optica. The involved tumor cases included: 8 cases of astrocytomas, 5cases of ependymomas, 2 cases of metastasis and one case of hemangioblastoma. In the post-contrast study: the demyelinating group patients showed faint enhancement in 11 cases and no enhancement in 7 cases. While the intramedullary tumors all cases showed enhancement. 12 cases showed marked enhancement and 4 cases with mild enhancement Qualitative DTI...

Conclusion

DTI derived metrics and tractography could be useful in differentiating between intramedullary tumors and tumor mimics.

Personal information and conflict of interest

D. K. M. Khedr (Doaa Khedr), lecturer, MD of diagnostic radiology, radiology department. Faculty of Medicine, Mansoura University. Postal code:35516. Phone:+201005571245. E-mail: [email protected] or [email protected].

References

1.Fanous, A. A., Olszewski, N. P., Lipinski, L. J., Qiu, J., & Fabiano, A. J. (2016). Idiopathic Transverse Myelitis Mimicking an Intramedullary Spinal Cord Tumor.Case reports in pathology,1:8.‏ 2.Abdelgawad, M. S., Reda, M. I. S., & El, N. A. E. M. A. (2017). Diffusion tensor MR fiber tractography in assessment of inflammatory processes and neoplasms of the cervical cord.The Egyptian Journal of Radiology and Nuclear Medicine,48(2), 431-437.‏ 3.Liu, X., Tian, W., Kolar, B., Hu, R., Huang, Y., Huang, J., & Ekholm, S. (2014). Advanced MR...