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Differentiation between intraspinal schwannoma and meningioma by MR characteristics and clinic features

  • Xiaodong Zhai
  • Ming Zhou
  • Hongwei Chen
  • Qunfeng Tang
  • Zhimin Cui
  • Yong YaoEmail author
  • Qihua YinEmail author
MAGNETIC RESONANCE IMAGING
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Abstract

Objectives

To retrospectively review the MRI characteristics and clinic features and evaluate the effectiveness of MR imaging in differentiating intraspinal schwannomas and meningiomas, with the excised histopathologic findings as the reference standard.

Materials and methods

One hundred and four schwannomas (M/F, 57:47) and 53 meningiomas (M/F, 13:40) underwent MR examinations before surgical treatment. Simple clinic data and imaging findings were considered:(a) location (craniocaudal and axial), (b) size, (c) morphology, (d) dural contact, (e) signal characteristics, (f) enhancement degree and patterns. The usefulness of the algorithm for differential diagnosis was examined between the two tumors.

Results

Interobserver agreement was good (κ = 0.7–0.9). Ten cases meningiomas demonstrated multiple lesions. There was a female predominance in the meningiomas (P < 0.001). Meningiomas predominantly were located in the ventral or anterolateral areas of thoracic regions, while schwannomas in the posterolateral areas of the thoracic and the lumbar regions (P < 0.001). Mean size of the lesions was 1.47 ± 0.36 cm for meningioma, and 2.02 ± 1.13 cm for schwannoma (P < 0.001). A dumbbell shape with intervertebral foramen widening could detect schwannomas, while the “dural tail sign” did meningiomas (P < 0.001). Hypointense and miscellaneous signal implied meningioma on T1WIs (P < 0.001). Isointense was more frequently observed in the meningiomas, while the fluid signal intensity and miscellaneous signal in the schwannomas on T2WIs (P < 0.001). Schwannomas usually manifested rim enhancement, while meningiomas diffuse enhancement (P = 0.005). There were six variables including the logistic equation (age, size, dural tail sign, morphology, T2WI, and axial location). The accuracy of the algorithm in diagnosis of schwannomas was 87.1%.

Conclusions

Combination of clinic data and MRI performs significantly for differentiating between intraspinal meningiomas and schwannomas.

Keywords

Spinal meningioma Schwannoma Magnetic resonance imaging 

Notes

Compliance with ethical standards

Conflict of interest

No conflict of interest exists in the submission of this manuscript, and manuscript is approved by all authors for publication. I would like to declare on behalf of my co-authors that the work described was original research that has not been published previously, and not under consideration for publication elsewhere, in whole or in part. All the authors listed have approved the manuscript that is enclosed.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

This retrospective study was approved by our institutional review board, and the requirement for informed consent was waived.

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Copyright information

© Italian Society of Medical Radiology 2019

Authors and Affiliations

  1. 1.Department of RadiologyThe Affiliated Wuxi People’s Hospital of Nanjing Medical UniversityWuxiChina
  2. 2.Department of OphthalmologyThe Affiliated Wuxi People’s Hospital of Nanjing Medical UniversityWuxiChina

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