MRI diagnosis and preoperative evaluation for pure epidural cavernous hemangiomas

Feng, Jie; Xu, Yu; Li, Long; Ruimeng, Yang; Ye, Xianghua; Zhang, Nan; Tian, Yu; Lin, Bei

doi:10.1007/s00234-009-0555-2

Cited by 41 publications

(73 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…MRI is the most reliable diagnostic tool for spinal epidural CAs (5). On MRI, epidural CAs are usually creeping growth and showed lobulated-spindle shaped with taper ends, which may be due to the softer texture of the CA and the limited epidural space (14). Owing to stagnant blood and slow blood flow, they are generally isointense on T1-WI and hyperintense on T2-WI (14,22).…”

Section: Discussionmentioning

confidence: 99%

“…On MRI, epidural CAs are usually creeping growth and showed lobulated-spindle shaped with taper ends, which may be due to the softer texture of the CA and the limited epidural space (14). Owing to stagnant blood and slow blood flow, they are generally isointense on T1-WI and hyperintense on T2-WI (14,22). Contrast-enhanced T1-WI shows homogeneous enhancement because of much sinusoid structure in the tumor (4); nevertheless, sometimes heterogeneous signal can also be noticed due to intralesional hemorrhage or thrombus (10,14).…”

Section: Discussionmentioning

confidence: 99%

“…Owing to stagnant blood and slow blood flow, they are generally isointense on T1-WI and hyperintense on T2-WI (14,22). Contrast-enhanced T1-WI shows homogeneous enhancement because of much sinusoid structure in the tumor (4); nevertheless, sometimes heterogeneous signal can also be noticed due to intralesional hemorrhage or thrombus (10,14). The most striking difference in the MRI characteristics between epidural and intramedullary CAs is the lack of a ring of hypointensity from hemosiderin deposit (9,16).…”

Section: Discussionmentioning

confidence: 99%

“…In our group, most of the lesions grow dorsally within the spinal canal. The larger available epidural space and the lower resistance in the posterior portion of the spinal canal may be explanations (5,14). In 6 cases, the tumors grew into the intervertebral foramen, which may be due to the loose tissue structure inside the neuroforamen (15,23).…”

Section: Discussionmentioning

confidence: 99%

“…Solitary epidural CAs not originating from the vertebral bone are relatively rare. With the aid of magnetic resonance imaging (MRI), solitary epidural CAs are being discovered in increasing numbers; nevertheless, most previous studies are case reports with an associated literature review and large series studies are very limited in the literature (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). Because of the risk of spontaneous and intraoperative bleeding, solitary epidural CAs need to get neurosurgeons more attention.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Clinical characteristics and surgical outcomes of solitary spinal epidural cavernous angiomas

2018

View full text Add to dashboard Cite

Abstract. The majority of spinal cavernous angiomas (CAs) originate from the vertebral bodies with or without epidural space extension. Solitary epidural CAs are rare. In the present study, we retrospectively reviewed the records of 12 patients who underwent microsurgery for solitary spinal epidural CAs. All patients had performed pre-and postoperative magnetic resonance imaging. The patients were 7 females and 5 males with the mean age of 52.1 years. Two tumors were located in the cervicothoracic spine, nine in the thoracic spine and one in the lumbar spine, respectively. Solitary epidural CAs generally exhibited isointensity on T1-weighted images and hyperintesity on T2-weighted images. Contrast-enhanced T1-weighted images showed homogeneous markedly enhancement. Gross total resection (GTR) was achieved in 11 cases, and subtotal resection (STR) was achieved in 1 case. During an average follow up of 35.9 months, neurological function was improved in 11 patients and in one patient, preoperative status was maintained. No patient experienced tumor recurrence. These findings suggest that CAs should be considered in the differential diagnosis of spinal epidural lesions. Early surgery is advocated to prevent irreversible neurological deficits. When aggravated by a large amount of acute hemorrhage, neurological deterioration is usually acute and prompt surgical decompression is the optimal choice. Because of the excessive vascularity of CAs, en bloc resection is recommended. In addition, a good clinical outcome after GTR can be expected, and the risk of long-term recurrence is low.

show abstract

Section: Discussionmentioning

confidence: 99%