title: Differentiation between intramedullary spinal ependymoma and astrocytoma: comparative MRI analysis.
abstract: OBJECTIVE
  To investigate magnetic resonance imaging (MRI) findings that could be used to differentiate intramedullary spinal ependymoma from astrocytoma, and to determine predictors for this differentiation.
  
  
  METHODS
  MRI images of 43 consecutive patients with pathologically proven intramedullary spinal ependymoma (n = 24) and astrocytoma (n = 19) were comparatively evaluated with regard to size, location, margin, signal intensity, contrast enhancement, presence of syringohydromyelia, tumoural cyst, non-tumoural cyst, and haemorrhage. MRI findings and demographic data were compared between the two tumour groups using univariate and multivariate logistic regression analyses.
  
  
  RESULTS
  In patients with ependymoma, older age and a larger solid component were more often observed than in astrocytoma. Central location, presence of enhancement, diffuse enhancement, syringohydromyelia, haemorrhage, and cap sign were more frequently observed in ependymoma. However, multivariate analysis revealed that syringohydromyelia was the only variable able to independently differentiate ependymoma from astrocytoma, with an odds ratio of 62.9 (95% CI: 4.38-903.22; p = 0.002).
  
  
  CONCLUSIONS
  Among the various findings, the presence of syringohydromyelia is the main factor distinguishing ependymoma from astrocytoma.
authors.affiliation: Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: D H
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea; The Institute of Radiation Medicine, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: jihnkim@gmail.com.
authors.forename: J-H
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea; The Institute of Radiation Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: S H
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea; The Institute of Radiation Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: C-H
authors.initials: CH
authors.lastname: Sohn
authors.affiliation: Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea; The Institute of Radiation Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: T J
authors.initials: TJ
authors.lastname: Yun
authors.affiliation: Department of Neurosurgery, Seoul National University, Seoul, Republic of Korea.
authors.forename: C H
authors.initials: CH
authors.lastname: Kim
authors.affiliation: Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea; Department of Radiology, Soonchunhyang University Bucheon Hospital, Seoul, Republic of Korea.
authors.forename: K-H
authors.initials: KH
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001254:Astrocytoma / Q000175:diagnosis / Q000473:pathology*; D002648:Child; D003937:Diagnosis, Differential; D004806:Ependymoma / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013120:Spinal Cord Neoplasms / Q000175:diagnosis / Q000473:pathology*; D013595:Syringomyelia / Q000175:diagnosis / Q000473:pathology*