Differentiating between spinal schwannomas and meningiomas using MRI: A focus on cystic change

Abstract

ObjectivesTo retrospectively determine the diagnostic ability of MRI in differentiating between intradural extramedullary spinal schwannomas and meningiomas. MethodsA total of 199 patients with spinal intradural extramedullary tumors who underwent preoperative contrast-enhanced MRI between January 2012 and December 2018 were included in this study. Two radiologists independently analyzed the presence of cystic change, dural tail sign, and neural foraminal extension. Clinical and MRI features between the two groups were compared by univariable and multivariable analyses using logistic regression. Interobserver agreements were calculated using kappa statistics.

The value of quantitative magnetic resonance imaging signal intensity in distinguishing between spinal meningiomas and schwannomas

“…In this study, the tumor size of schwannomas (median 11.9; 95% CI: 7.7-59.6) was significantly larger than that of meningiomas (median 9.73; 95% CI: 6.5-23.9). The study by Lee et al [10] also reported a similar result. Additionally, our study found that men were significantly more likely to be diagnosed with schwannoma than meningioma, and schwannomas were significantly more likely to be located in the cervical and lumbar spine and in a lateral position on the horizontal axis.…”

“…Schwannomas presented with a heterogeneously hyperintense signal on T2W in the study reported by Verdelhan et al 11 . The studies by Iwata et al 14 , Zhai et al 2 , and Lee et al 10 also reported significantly increased fluid signals on T2W in schwannomas are significantly higher than those of meningiomas. The fluid signals are indicated by signal intensity equal to that of the cerebrospinal fluid, exhibiting hypointense on T1WI, hyperintense on T2WI and show no enhancement after contrast administration.…”

“…The age of patients diagnosed with meningiomas in our study (median 61 years, 95%, CI: 41-83 years) was significantly higher than those diagnosed with schwannomas (median 49 years, 95% CI: 18-86 years), which is similar to study reported by Iwata et al 14 , in which the mean age of patients with meningioma was 68 years, ranging from 39 to 85 years, and the mean age of patients with schwannoma was 56.2 years, ranging from 18 to 84 years. Furthermore, the study by Lee et al 10 reported a mean age for the meningioma group of 59.7 years, whereas those with schwannomas had a mean age of 47.6 years. Previous studies have predominantly agreed that the mean age of patients with schwannomas is significantly higher than that of patients with meningiomas.…”

“…Some recognized advantages of MRI assessment include its non-invasive nature and the ability to obtain high-quality images without radiation exposure [6,8]. Although pathology remains the gold standard for final tumor diagnoses, the benefits of preoperative, MRI-based histopathologic type predictions are becoming more widely acknowledged and accepted [2,[9][10][11][12].…”

Intradural Extramedullary Spinal En-Plaque Meningioma With Calcification: A Case Report And Literature Review

“…If a calcified area is included, the signal may change to low. [3], [7] Management of spinal IDEM tumors is tumor resection surgery but biopsy is the only method to definitively confirm diagnosis through tumor resection surgery. [8], [9], [10] The pathognomonic histologic feature of a meningioma is spherical formations of meningothelial cells, called whorls, which eventually mineralize into psammoma bodies.…”