Spinal schwannoma diagnosis [Neurosurgery Wiki]

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====== Spinal schwannoma diagnosis ======

{{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/1diOUTbPywnor4hSYnuGBy9w5uxoEHsrEGb9yLwW_8iwv8dQY8/?limit=15&utm_campaign=pubmed-2&fc=20230706072109}}

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[[Convolutional neural network]]-based MRI analysis has the potential to accurately differentiate ependymomas from schwannomas in the lumbar segment
((Gu Z, Dai W, Chen J, Jiang Q, Lin W, Wang Q, Chen J, Gu C, Li J, Ying G, Zhu Y. Convolutional neural network-based magnetic resonance image differentiation of filum terminale ependymomas from schwannomas. BMC Cancer. 2024 Mar 19;24(1):350. doi: 10.1186/s12885-024-12023-0. PMID: 38504164.))
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The final diagnosis should be established by clinical findings and imaging methods and MRI is the best method for diagnosis and differential diagnosis.

The size and specific margins of the mass demonstrate the localization and invasion to the contiguous structures. The changes such as foramen enlargement and erosion in the pedicles detected in the direct graphs may be seen as masses with sharp margins and involve the peripheral contrast in the CT scans.

Paraspinal schwannomas are frequently asymptomatic and diagnosed incidentally on imaging of the spine 
((Chamberlain MC, Tredway TL. Adult primary intradural spinal cord tumors: A review. Curr Neurol Neurosci Rep. 2011;11(3):320–8.)).

===== Radiographic features =====

Schwannomas are in most instances indistinguishable from neurofibromas. Refer to the article on spinal nerve sheath tumors for a discussion of their radiographic appearance.

The vast majority of spinal schwannomas are intradural extramedullary in location. Rarely (1%), intramedullary tumors are found 
((Koeller KK, Shih RY. Intradural Extramedullary Spinal Neoplasms: Radiologic-Pathologic Correlation. (2019) Radiographics : a review publication of the Radiological Society of North America, Inc. 39 (2): 468-490. doi:10.1148/rg.2019180200))

They are most frequently seen in the cervical and lumbar regions, far more frequently than in the thoracic spine.

In general, schwannomas appear as solid, well-defined, rounded lesions, often with associated adjacent bony remodeling. When large, they may either align themselves with the long axis of the cord, forming sausage-shaped masses that can extend over several levels, or may protrude out of the neural foramen, forming a dumbbell-shaped mass. 

===== Spine magnetic resonance imaging =====

[[Spine magnetic resonance imaging for Spinal schwannoma diagnosis]].