[Intramedullary spinal cord tumors : MRI diagnosis and differential diagnosis].

BACKGROUND

Intramedullary spinal cord tumors are rare neoplasms but frequently cause significant neurological deficits because of the limited compensatory capacity of the spinal cord. Magnetic resonance imaging (MRI) is the imaging modality of choice and often allows a reliable differential diagnosis based on characteristic imaging findings.

OBJECTIVES

To provide a practical neuroradiological approach to the diagnosis of intramedullary spinal cord tumors, including recent developments in the World Health Organization (WHO) classification.

MATERIALS AND

METHODS

Narrative review of the current literature regarding epidemiology, imaging characteristics, WHO classification, and differential diagnosis of intramedullary spinal cord tumors.

RESULTS

Ependymomas, astrocytomas, and hemangioblastomas account for the majority of intramedullary tumors. Tumor location, longitudinal extent, enhancement pattern, hemorrhagic components, syringomyelia, and flow voids substantially narrow the differential diagnosis. Recent WHO classifications increasingly incorporate molecular markers, including MYCN-amplified spinal ependymoma and H3 K27-altered diffuse midline glioma.

CONCLUSION

Structured MRI assessment frequently enables a reliable preoperative diagnosis. Inflammatory, vascular, and ischemic disorders must always be considered as important differential diagnoses.