Interactive Transcript
0:00
This was a young adult patient who presented
0:03
with myelopathy with tingling and paresthesias
0:07
in the upper extremities.
0:09
Here we have a sagittal T2-weighted,
0:12
a sagittal STIR and a post-gadolinium enhanced scan.
0:15
What we see is a focal lesion
0:17
within the spinal cord.
0:19
We note that the CSF space narrows at the
0:22
level of the spinal cord, identifying it as an
0:25
intradural intramedullary lesion which has mass effect.
0:29
Again, narrowing of the CSF space
0:32
at the border with the mass.
0:35
This mass is small in size and relatively well defined.
0:39
Again, we get that sense of the expansion of the
0:42
spinal cord on the T2-weighted and the STIR image.
0:47
On post-gadolinium enhanced scan,
0:49
we do see focal enhancement.
0:51
This more focal lesion that is relatively
0:56
confined to a small area in the spinal cord
0:59
is most in keeping with an ependymoma of the spinal cord.
1:04
Astrocytomas, by and large, are more diffuse,
1:08
elongated lesions, whereas ependymomas may
1:11
be small in size and well-defined.
1:15
Another of the features that we look for with
1:17
ependymomas is the so-called hemosiderin cap sign.
1:21
And that is that the ependymomas
1:23
sometimes will show hemorrhage.
1:24
And what you might see is a little rim of dark
1:27
signal intensity at the edge of the lesion,
1:30
which may be that edge of hemosiderin that
1:34
is associated with the cord lesion.
1:36
In this case,
1:37
the lesion shows contrast enhancement and that is
1:40
typical of nearly all of the neoplasms
1:43
that occur within the spinal cord.
© 2024 MRI Online. All Rights Reserved.