Intracranial and spinal ependymomas: review of MR images in 61 patients.
OBJECTIVE
To compare the age distribution and characteristic MR imaging findings of ependymoma for each typical location within the neuraxis.


METHODS
During a recent eleven-year period, MR images of 61 patients with histologically proven ependymomas were obtained and retrospectively reviewed in terms of incidence, peak age, location, size, signal intensity, the presence or absence of cyst and hemorrhage, enhancement pattern, and other associated findings.


RESULTS
Among the 61 patients, tumor location was spinal in 35 (57%), infrartentorial in 19 (31%), and supratentorial in seven (12%). In four of these seven, the tumor was located in brain parenchyma, and in most cases developed between the third and fifth decade. Approximately half of the infratentorial tumors occurred during the first decade. The signal intensity of ependymomas was nonspecific, regardless of their location. A cystic component was seen in 71% (5/7) of supratentorial, 74% (14/19) of infratentorial, and 14% (5/35) of spinal cord tumors. Forty- nine percent (17/35) of those in the spinal cord were associated with rostral and/or caudal reactive cysts. Intratumoral hemorrhage occurred in 57% (4/7) of supratentorial, 32% (6/19) of infratentorial, and 9% (3/35) of spinal cord tumors. In 17% (6/35) of spinal ependymomas, a curvilinear low T2 signal, suggesting marginal hemorrhage, was seen at the upper and/or lower margins of the tumors. Peritumoral edema occurred in 57% (4/7) of supratentorial, 6% (3/19) of infratentorial and 23% (8/35) of spinal cord tumors. Seventy-two percent (5/7) of supratentorial and 95% (18/19) of infratentorial tumors showed heterogeneous enhancement, while in 50% (17/34) of spinal cord tumors, enhancement was homogeneous.


CONCLUSIONS
Even though the MR imaging findings of ependymomas vary and are nonspecific, awareness of these findings, and of tumor distribution according to age, is helpful and increases the likelihood of correct preoperative clinical diagnosis.
Choi
Ja-Young
JY
Department of Radiology, Seoul National University College of Medicine, Korea.
Chang
Kee-Hyun
KH
Yu
In Kyu
IK
Kim
Keon Ha
KH
Kwon
Bae Joo
BJ
Han
Moon Hee
MH
Kim
In-One
IO
D000328:Adult; D017677:Age Distribution; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D004806:Ependymoma / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000175:diagnosis* / Q000453:epidemiology