MRI Imaging of Dumbbell Shaped Intra Dural Extramedullary Spinal Schwannoma

International Journal of Medical Science

© 2022 by SSRG - IJMS Journal

Volume 9 Issue 5

Year of Publication : 2022

Authors : Anju Dhiman, Parveen Chandna, Dalip Singh Dhiman, Mohammad Abdullah

10.14445/23939117/IJMS-V9I5P102

How to Cite?

Anju Dhiman, Parveen Chandna, Dalip Singh Dhiman, Mohammad Abdullah, "MRI Imaging of Dumbbell Shaped Intra Dural Extramedullary Spinal Schwannoma," SSRG International Journal of Medical Science, vol. 9,  no. 5, pp. 13-19, 2022. Crossref, https://doi.org/10.14445/23939117/IJMS-V9I5P102

Abstract:

Schwannomas are the most typical and frequent occurring intradural extramedullary tumors. These are wellencapsulated tumors that persist as cystic masses. In general, their origin is from the dorsal sensory root. Most neurinomas (about 3/4%) are solely intradural extramedullary tumors; about 1/7th have been found to be extradural. Still, more than 15% of the total have attained a "dumbbell" shape comprising both the intra- and extradural space. Neurinomas infiltrate the cervical and thoracic areas in about 3/5 % of cases and the remaining about 2/5 % in the lumbar area. Only Less than 1% exist inside the cord. Schwannomas are solitary tumors and never established in clumps. CT has been of immense use to critically expose bone erosion in its vicinity based at the foraminal canal, simultaneously associated with vertebral body scalloping. Calcifications are uncommon. On MRI imaging, neurinomas reveal isointense to the cord in about 7/10 % of the cases, while the remaining about 1/5th % reveal as moderately hypointense on T1-WI. On T2-WI, 95% of these lesions are hyperintense. Out of the total schwannomas, about 2/5 % have a cystic component. Hemorrhage has been depicted only in about 1/10 % of cases. Almost all schwannomas enhance intensely and homogeneously in contrast studies. A more heterogeneous pattern is prevalent in cystic conditions. Giant schwannomas have been critically noticed at the lumbar level and depicted to be almost indistinguishable from myxopapillary ependymoma or hemangiopericytoma. Neurofibromas are illdefined and often persist as multiple tumors, and have never been found to be completely encapsulated. Generally, MRI is unable to differentiate between a schwannoma and a neurofibroma, especially when the tumor is solitary. In neurofibromatosis type 1, multiple plexiform neurofibromas have been peculiarly encountered. These are iso-/hyperintense on T2-WI with a "target" aspect (hyperintense rim and low/intermediate center). Enhancement is typically mild. Specifically, Malignant degeneration may occur in a few cases, especially in the typical case of neurofibromatosis type 2.

Keywords:

MRI images, Spinal.

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