3-Tesla magnetic resonance imaging evaluation of intraspinal extramedullary nonosseous neoplastic lesions with their postsurgical and histopathological correlation

Abstract

Aims: This study aimed to evaluate the diagnostic ability of 3-Tesla magnetic resonance imaging (MRI) in detection and characterization of intraspinal extramedullary nonosseous neoplastic lesions and their histopathological correlation. Settings and Design: It was a prospective study involving fifty patients who presented with low backache and lower limb weakness with MRI findings suggestive of a neoplastic extramedullary intraspinal lesion. Patients and Methods: A 3-Tesla 16-channel MRI scanner was used for imaging. Multiplanar imaging was done using T1, T2, short-tau inversion recovery sequences and T1 fat-saturated sequences. All patients then underwent postgadolinium MRI. The findings of MRI were then reviewed. An analysis of correlation between MRI findings and surgical and histopathological findings was done. Results: Out of the fifty patients evaluated, intradural lesions were noted in forty patients and extradural lesions in ten patients. Schwannoma was the most common tumor, followed by meningioma in the intradural category. Two rare cases of intradural lipoma and malignant peripheral nerve sheath tumors were also detected. In extradural category, metastasis was the most common lesion along with two rare lesions of epidural meningioma and leukemia-associated granulocytic sarcoma. Conclusions: MRI is an indispensable tool in the evaluation of spinal neoplasms. Its multiplanar capability, high-quality soft-tissue resolution, and depiction of various anatomic landmarks help the neurosurgeon to make a road map for the surgery. In most of the cases, MRI can give information regarding the histopathology of the lesion. However, in some cases, differential diagnosis needs to be included, especially in cases of extradural meningiomas and malignant peripheral nerve sheath tumors, because of their rare incidence.