Spinal epidural hemangiomas: various types of MR imaging features with histopathologic correlation

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Lee, J.W.; Cho, E.Y.; Hong, S.H.; Chung, H.W.; Kim, J.H.; Chang, K.-H.; Choi, J.-Y.; Yeom, J.-S.; Kang, H.S.
Issue Date
American Society of Neuroradiology
AJNR Am J Neuroradiol 2007;28:1242-8
AdolescentCervical Vertebrae/pathologyChildChild, PreschoolEpidural Neoplasms/*pathologyFemaleHemangioma/*pathologyHumansImage Enhancement/*methodsImage Interpretation, Computer-Assisted/*methodsLumbar Vertebrae/pathologyMagnetic Resonance Imaging/*methodsMaleReproducibility of ResultsSensitivity and SpecificityStatistics as TopicThoracic Vertebrae/pathology
BACKGROUND AND PURPOSE: Because of the high vascularization of hemangiomas, preoperative misinterpretation may result in unexpected intraoperative hemorrhage and incomplete resection, which results in the persistence of clinical symptoms or recurrence. Our purpose was to analyze various MR imaging features of a spinal epidural hemangioma with histopathologic correlation. MATERIALS AND METHODS: After searching through the pathology data bases in 3 hospitals, we included 14 patients (9 male and 5 female; mean age, 38 years; age range, 2-62 years) with spinal epidural hemangiomas confirmed by surgical resection after MR imaging. Three radiologists reviewed the MR imaging in consensus and categorized the features into subtypes on the basis of histopathologic findings. RESULTS: We categorized the MR imaging features as follows: type A for a cystlike mass with T1 hyperintensity (2 cases, arteriovenous type with an organized hematoma), type B for a cystlike mass with T1 isointensity (3 cases, venous type), type C for a solid hypervascular mass (7 cases, cavernous type), and type D for an epidural hematoma (2 cases, cavernous type with hematoma). Types A and B had frequent single segmental involvement (4/5), whereas types C and D had multisegmental involvement in all. Regardless of MR types, lobular contour (8/14) and a rim of low T2 signal intensity (8/14) of the mass were common. T1 hyperintensity of the mass was occasionally seen (5/14). CONCLUSIONS: Spinal epidural hemangiomas can have various MR imaging features according to their different histopathologic backgrounds. In addition to common features such as solid hypervascularity, lobular contour, and a rim of low T2 signal intensity, T1 hyperintensity or multisegmental involvement may also be a clue in the differential diagnosis of a spinal epidural hemangioma.
0195-6108 (Print)
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Radiation Applied Life Science (대학원 협동과정 방사선응용생명과학전공)Journal Papers (저널논문_방사선응용생명과학)
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