• Eur Spine J · Feb 2019

    Variety of preoperative MRI changes in spinal cord ependymoma of WHO grade II: a case series.

    • Kazuyoshi Kobayashi, Kei Ando, Fumihiko Kato, Koji Sato, Mitsuhiro Kamiya, Mikito Tsushima, Masaaki Machino, Kyotaro Ota, Masayoshi Morozumi, Satoshi Tanaka, Shunsuke Kanbara, Sadayuki Ito, Naoki Ishiguro, and Shiro Imagama.
    • Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan.
    • Eur Spine J. 2019 Feb 1; 28 (2): 426-433.

    PurposeTo report a case series of surgically proven spinal ependymomas of WHO grade II in which there were changes in the preoperative MRI characteristics over time.MethodsA total of 71 patients with spinal cord ependymoma of WHO grade II underwent surgery. There were ten cases in which surgery was performed at an average of 2.2 years after the tumor was found. Cystic components, syringomyelia, hemorrhage "cap sign," Gd enhancement pattern, characteristic changes in MRI, MIB-1 index, and neurological assessment during the preoperative period were examined.ResultsCases with a huge cyst showed further enlargement of the cyst on the caudal and rostral sides with hemosiderin formation over time and changes in the pattern of Gd enhancement. In contrast, cases without initial cyst did not show cyst formation, and nodular homogeneous lesion remained without changes in Gd enhancement. Regarding neurological status, two cases with cyst enlargement and hemosiderin formation had worsened non-independent gait preoperatively.ConclusionsMRI in cases of spinal ependymomas of WHO grade II showed characteristics such as hemorrhage and cyst formation that varied over time. In particular, cases with cyst and hemosiderin showed tumor enlargement, including enlargement of lesions on the caudal and rostral sides and enlargement of Gd-enhanced lesions. These characteristics might influence gait ability during preoperative period. We emphasize that early surgery is still the standard of care for cervical intramedullary ependymoma, and our findings in this study should not be interpreted to indicate that such early surgery is not necessary in symptomatic cases. These slides can be retrieved under electronic supplementary material.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…