2019.06.13 [醫影] 脊髓腫瘤

Spinal tumor

主要分成以下三類
一. Intramedullary tumors.
二. Intradural extramedullary tumor
三. Extradural tumor

一. Intramedullary tumors.

1.Astrocytoma.
-more in children
-eccentric location in the spinal canal
-ill-defined
-hemorrhage is uncommon

2.Ependymoma
-most common spinal cord tumor, seen both in adult and pediatric population.
- C spine最常見, 其次合併T spine 以及T spine alone
-more well-circumscribed
-syringohydromyelia in 10-50% case
- T1 C+ (Gd): virtually all enhance strongly, somewhat inhomogeneously


3.Hemangioblastoma.
-T1+C: strong-enhancing

Modality: MRI (T1 C+)

- “ Histology proven hemangioblastoma of the spine. Note the large flow voids and marked holocord syringomyelia. ”

Others are very rare.

二. Intradural extramedullary tumor

1. Meningioma.
- 好發T-spine.
- 中年女性

- T1: iso, T2: hyper, T1+C: vivid enhancement   (more homogenous than Schwannoma)

- 
- May calcification(due to psammoma body)

2.Neurilemmoma
-also named schwannoma
-May has extradural extension via the neuroforamen, and forming as "dumbbell " shape.
Others are very rare.

- T1: iso, T2: hyper, T1+C: vivid enhancement

三. Extradural tumor

Intraspinal canal: 
-Lymphoma, hemangioma, metastasis.....

Vertebral bodies:
-metastasis, bony tumor at vertebra

Paravertebral space: 
-Metastasis