MRI Evaluation of Intradural Extramedullary Spinal Tumors with Histopathological Correlation - A Cross Sectional Study

Abstract

Introduction: Tumors of nerve sheath, neurofibroma and schwannoma represent 30% of intradural extramedullary tumors. Schwannomas and neurofibromas are histologically composed of Schwann cells. Schwannomas almost always arise from the dorsal sensory roots and form well- encapsulated firm masses that compress adjacent tissue, without invading the involved nerve. Neurofibromas are more complex and are composed of Schwann cells mixed with fibroblast they involve the parent nerve. Meningiomas comprise approximately 25% of primary intraspinal tumors and are second only to nerve sheath tumors in frequency. Spinal cord meningiomas are originate from meningothelial cells near the distal root ganglia. Most menongiomas are intradural extramedullary, only 5% are extradural. Aim of the Study: The aim of this study was to evaluate the role of MRI in diagnosis of intradural extramedullary spinal tumors compared to histopathological findings. Methods: This was a cross sectional study and was conducted in the Department of Radiology and Imaging, Sylhet M.A.G. Osmani Medical College, Sylhet in collaboration with Department of Neurosurgery & Pathology of the same hospital, Sylhet, Bangladesh during the period from September, 2018 to August 2020. Result: In total 35 patients completed the study. In our study we found the Mean ± SD of age was 41.71±13.9 in years. Majority (54%) of our patients presented with spinal tumor were male compared to female (46%).We found schwannoma was diagnosed by (42.9%), meningioma (31.4%), neurofibroma (25.7%) respectively. Neurofibroma & schwannoma showed male predominance with 66.67% & 60% while meningioma showed female predominance with 63.6%. We found majority (55.6%, 60% & 72.7%) of neurofibroma, schwannoma & meningioma was in dorsal region respectively. Conclusion: In our study we found that MRI is a very sensitive and effective imaging procedure of suspected spinal schwannoma tumor of the spinal cord for accurate pre-operative diagnosis and ........