Intradural extramedullary spinal tumor diagnosis
Radiographic features
Intradural extramedullary masses can have a number of general morphological features:
solitary vs multiple may have a dural tail (especially meningiomas) may have a nerual exit foraminal (extradural) component (i.e dumbbell appearance) 3
Plain film
may be normal expansion of the spinal canal or intervertebral foramina may show a paravertebral mass (more suggestive of a nerve sheath tumour)
CT
purely intradural lesions may not be shown extradural extension bone erosion and sclerosis heavy calcification is rare in spinal meningiomas and nerve shealth tumours; a heavily calcified intraspinal mass is usually extradural extruded disc material
Myelography
deviation of the spinal cord away from mass Ipsilateral subarachnoid space enlargement contralateral subarachnoid space effacement intradural filling defect outlined by sharp meniscus of contrast (“meniscus sign”). the subarachnoid space is blocked and CSF above the block remains unopacified.