title: MR imaging features that distinguish spinal cavernous angioma from hemorrhagic ependymoma and serial MRI changes in cavernous angioma.
abstract: Cavernous angiomas of the spinal cord exhibit imaging characteristics that may overlap with those of hemorrhagic ependymoma. In the present study, we aimed to identify specific magnetic resonance imaging (MRI) findings that could be used to differentiate cavernous angioma from hemorrhagic ependymoma, and to evaluate serial MRI changes in cases of cavernous angioma. We retrospectively evaluated MR images of spinal cord tumors collected at our hospital from 2007 to 2015. From this cohort of images, 11 pathologically confirmed cavernous angiomas and 14 pathologically confirmed hemorrhagic ependymomas were compared with respect to the size of the tumor, longitudinal location, axial location, enhancement pattern, syrinx, edema, tumor margin, signal intensity of T2WI, signal intensity of T1WI, and longitudinal spreading of the hemorrhage. Serial MR images of seven spinal cavernous angiomas were reviewed. Small size, eccentric axial location, minimal enhancement, and absence of edema were more frequently observed on images of cavernous angioma compared to those of hemorrhagic ependymoma (p < 0.01). Serial MRI changes in cases of cavernous angioma included increased longitudinal spreading of the hemorrhage (6/7, 86 %) and emergence of high signal intensity on T1WI (1/7, 14 %). Small size, eccentric axial location, minimal enhancement, and absence of edema are significant MRI findings that may be used to distinguish Type I and Type II spinal cavernous angiomas from hemorrhagic ependymomas. Furthermore, longitudinal spreading of the hemorrhage may be observed on follow-up MRIs of cavernous angiomas.
authors.affiliation: Department of Radiology, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 135-720, South Korea.
authors.forename: Inhwan
authors.initials: I
authors.lastname: Jeon
authors.affiliation: Department of Radiology, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 135-720, South Korea.
authors.forename: Woo Sang
authors.initials: WS
authors.lastname: Jung
authors.affiliation: Department of Radiology, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 135-720, South Korea.
authors.forename: Sang Hyun
authors.initials: SH
authors.lastname: Suh
authors.affiliation: Department of Radiology, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 135-720, South Korea.
authors.forename: Tae-Sub
authors.initials: TS
authors.lastname: Chung
authors.affiliation: Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, 135-720, South Korea.
authors.forename: Yong-Eun
authors.initials: YE
authors.lastname: Cho
authors.affiliation: Department of Radiology, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 135-720, South Korea. aahng77@yuhs.ac.
authors.forename: Sung Jun
authors.initials: SJ
authors.lastname: Ahn
mesh_terms: D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D004806:Ependymoma / Q000000981:diagnostic imaging* / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006392:Hemangioma, Cavernous / Q000150:complications* / Q000628:therapy*; D006474:Hemorrhagic Disorders / Q000150:complications*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013120:Spinal Cord Neoplasms / Q000175:diagnosis* / Q000209:etiology*
keywords: Cavernous angioma; Ependymoma; Hemorrhage; Spinal cord