Spine magnetic resonance imaging for Spinal schwannoma diagnosis

• Large Anterior Cervical Spine Schwannoma Causing Dysphagia: Case Report
• Rare case of a massive anterior mediastinal schwannoma causing cardiac compression with concurrent cervical spine lesion causing spinal cord compression
• Upper thoracic spinal schwannoma leading to intracranial hypertension and hydrocephalus: A case report and literature review
• Minimally Invasive Lateral Retroperitoneal Approach for Resection of Extraforaminal Lumbar Schwannomas: Results After 1-Year Follow-Up
• A giant spinal schwannoma at the C1-C2 level: A case report
• Management strategies for cervical schwannomas: a comprehensive review
• Hybrid nerve sheath tumor of the spinal canal and neurofibromatosis-2, where the twain shall meet-a case report and review of literature
• Cavernoma of the cauda equina mimicking schwannoma: A case report

see also Spine magnetic resonance imaging for spinal cord tumor diagnosis

Spine magnetic resonance imaging (MRI) is a commonly used imaging modality for the diagnosis of spinal schwannomas. MRI provides detailed visualization of the soft tissues, including the spinal cord, nerve roots, and surrounding structures, allowing for the detection and characterization of spinal tumors. Here's how MRI is utilized in the diagnosis of spinal schwannomas:

Tumor Localization: MRI helps identify the exact location of the spinal schwannoma along the spine. It provides information on the vertebral level and the relationship of the tumor to adjacent structures.

Tumor Characteristics: MRI can help determine the size, shape, and extent of the schwannoma. It provides information on the tumor's relationship to the spinal cord, nerve roots, and surrounding tissues. The MRI images can help differentiate between intradural (within the protective covering of the spinal cord) and extradural (outside the spinal cord) schwannomas.

Tumor Enhancement: Spinal schwannomas typically show contrast enhancement on MRI. Intravenous administration of a contrast agent during the MRI scan can help highlight and differentiate the tumor from the surrounding tissues.

Spinal Cord Compression: MRI can assess the degree of spinal cord compression caused by the schwannoma, helping determine the potential impact on neurological function.

Differential Diagnosis: MRI can aid in distinguishing spinal schwannomas from other spinal tumors or conditions, such as meningiomas, neurofibromas, or metastatic tumors, based on their characteristic imaging features Quantitative SI values (T2max, T2mean, T2min, T1CEmax, rTF) can be used to differentiate intradural-extramedullary schwannomas from meningiomas ¹⁾ The presence of cystic change and dural tail signs were independently significant discriminators ²⁾.

Evaluation of Neurological Structures: MRI provides visualization of the spinal cord, nerve roots, and surrounding soft tissues, allowing assessment for any associated nerve root compression, spinal cord edema, or other neurological abnormalities.

In addition to MRI, other imaging techniques such as computed tomography (CT) scans may be used to complement the diagnosis and provide additional information on bone involvement or spinal stability.

Although neurofibromas and schwannomas can look identical in Spine magnetic resonance imaging, schwannomas are frequently associated with hemorrhage, intrinsic vascular changes (thrombosis, sinusoidal dilatation), cyst formation, and fatty degeneration. These findings are rare in neurofibromas ³⁾

Signal characteristics include ⁴⁾:

75% are isointense, 25% are hypointense.

More than 95% are hyperintense, often with mixed signal

Virtually 100% enhance

An exception to the above signal characteristics is melanotic schwannomas, which are T1 hyperintense and T2 hypointense.