The Correspondence Between Magnetic Resonance Images and the Clinical and Intraoperative Status of Patients with Spinal Tumors.

Abstract

Abstract introduction: Surgical treatment of tumors, particularly metastases to the spine, has become increasingly common owing to the progress in anesthesiology and spinal surgery and greater detectability. The patients qualified for surgeries are those with mechanical pain, fracture or at risk of vertebral fracture or neurological complications. The basis for qualification for different types of surgeries is clinical and imaging examination, particularly MRI and CT. Qualification should always be multidisciplinary and requires understanding and knowledge of its most essential aspects. When carrying out imaging examinations, it is necessary to assess the size and the type of the tumor, taking into account of differential diagnosis. One should also consider the factors indicating spinal instability or the onset of neurological deficits. The criteria developed by Kostiuk-Weinstain and Taneichi are used for that purpose. The aim of the present study was to evaluate the correspondence between the most essential elements of clinical and MRI examination of the spine and the intraoperative status of patients with spinal tumors.

Materials and methods: We carried out prospective examination assessing the correspondence between the clinical status and MR images and the intraoperative spine. We introduced algorithm to describe the morphology of neoplastic lesions within the spine.

Results: The information obtained from the clinical examination and the intraoperative status of the spine corresponded with the MRI examination with the exception of the assessment of neoplastic infiltration to soft tissues, dura mater and nerve roots. It was also found that there are no clear-cut MRI features allowing differentiation of metastatic lesions from primary tumors and osteitis. Furthermore, MRI examination does not allow for the assessment of the quality of bone tissue in the vicinity of the tumor.