MRI diagnosis and preoperative evaluation for pure epidural cavernous hemangiomas.
BACKGROUND
The aims of the study were to summarize the characteristics of the spinal epidural cavernous hemangioma, especially for the MRI, and to improve the accurate rate of the preoperative diagnosis.


METHODS
The clinical and medical imaging data of six patients with pure spinal epidural cavernous hemangioma proved by operation and pathology were analyzed retrospectively.


RESULTS
The level was thoracic (n = 2), thoracolumbar (n = 1), lumbar (n = 1), and sacral (n = 2). The tumor showed lobulated contour, and the areas the tumors appeared were dorsal side of spinal cord (n = 2), ventral side (n = 1), and lateral side (n = 3). In all six patients, the lesions were isointense to the spinal cord on T(1)-weighted images and hyperintense on T(2)-weighted images and showed homogeneously strong enhancement on contrast-enhanced T(1)-weighted images. The characteristic MRI features were named as the "wafting-silk" sign. Widening of the intervertebral neural foramen (n = 4) and erosion of the adjacent bones (n = 3) can be observed.


CONCLUSIONS
MRI of the epidural cavernous hemangioma showed the characteristic lobulated contour, which encircled the spinal cord. T(1)WI on the MRI presented as isointense and T(2)WI presented as hyperintense and a homogeneously strong enhancement, so we first proposed the sign of wafting silk. The widening of the intervertebral neural foramen and erosion of the adjacent bones can easily be observed. MR imaging has an important role in the detection and diagnosis of pure spinal epidural cavernous hemangioma.
Feng
Jie
J
Department of Diagnostic Imaging Center, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, Guangdong 510515, China.
Xu
Yi-Kai
YK
Li
Long
L
Yang
Rui-Meng
RM
Ye
Xiang-Hua
XH
Zhang
Nan
N
Yu
Tian
T
Lin
Bing-Quan
BQ
D000293:Adolescent; D000328:Adult; D015174:Epidural Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D020786:Hemangioma, Cavernous, Central Nervous System / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010784:Photomicrography; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D012447:Sacrum; D013116:Spinal Cord / Q000473:pathology* / Q000601:surgery; D013904:Thoracic Vertebrae