Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Medical Imaging
Published in: BMC Medical Imaging 1/2019

Open Access 01-12-2019 | Ependymoma | Research article

MR imaging features of spinal pilocytic astrocytoma

Authors: De-jun She, Yi-ping Lu, Ji Xiong, Dao-ying Geng, Bo Yin

Published in: BMC Medical Imaging | Issue 1/2019

Login to get access

Abstract

Background

The purpose of this retrospective review is to determine the MR imaging features of pilocytic astrocytoma (PA) in the spinal cord to help neuroradiologists preoperatively differentiate PA from other intramedullary tumors.

Methods

Neuro-oncology database review revealed 13 consecutive patients with a pathological spinal PA diagnosis and availability of preoperative MR imaging. Three patients had preoperative diffusion-weighted MR imaging. Demographics and conventional and diffusion MR imaging records were retrospectively evaluated.

Results

Among 13 cases of spinal PA, six PAs were located in the cervical region, 4 in the cervical-thoracic region, and 3 in the thoracic region. The average length of vertebral segments involved for the tumors were 4.7 ± 4.6 segments. Six tumors had associated syringomyelia. Eight PAs were located eccentrically in the spinal cord, and eleven had well-defined margins. Eight tumors (61.5%) were intermixed cystic and solid. All were contrast-enhanced, and 53.8% of all PAs showed focal nodule enhancement of the solid components. Two PAs showed intratumoral hemorrhages, and only one demonstrated cap sign. The ADC values (n = 3) of the tumors were 1.40 ± 0.28 × 10− 3 mm2/s (min–max: 1.17–1.71 × 10− 3 mm2/s).

Conclusions

PA should be considered in the differential diagnosis of intramedullary tumors that occur in the cervical and thoracic regions. Eccentric growth pattern, well-defined margin, intermixed cystic and solid appearance, focal nodular enhancement of solid components and syringomyelia are relatively frequent features. Relatively high ADC values compared with normal-appearing spinal cord parenchyma are common in spinal PA.
Literature
1.
Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, Ohgaki H, Wiestler OD, Kleihues P, Ellison DW. The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol. 2016;131(6):803–20.PubMedCrossRef
2.
Burkhard C, Di Patre PL, Schuler D, Schuler G, Yasargil MG, Yonekawa Y, Lutolf UM, Kleihues P, Ohgaki H. A population-based study of the incidence and survival rates in patients with pilocytic astrocytoma. J Neurosurg. 2003;98(6):1170–4.PubMedCrossRef
3.
Johnson DR, Brown PD, Galanis E, Hammack JE. Pilocytic astrocytoma survival in adults: analysis of the surveillance, epidemiology, and end results program of the National Cancer Institute. J Neuro-Oncol. 2012;108(1):187–93.CrossRef
4.
Ostrom QT, Gittleman H, Liao P, Vecchione-Koval T, Wolinsky Y, Kruchko C, Barnholtz-Sloan JS. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2010-2014. Neuro-Oncology. 2017;19(suppl_5):v1–v88.PubMedPubMedCentralCrossRef
5.
Raco A, Esposito V, Lenzi J, Piccirilli M, Delfini R, Cantore G. Long-term follow-up of intramedullary spinal cord tumors: a series of 202 cases. Neurosurgery. 2005;56(5):972–81 discussion 972-981.PubMed
6.
Eroes CA, Zausinger S, Kreth FW, Goldbrunner R, Tonn JC. Intramedullary low grade astrocytoma and ependymoma. Surgical results and predicting factors for clinical outcome. Acta Neurochir. 2010;152(4):611–8.PubMedCrossRef
7.
Horger M, Ritz R, Beschorner R, Fenchel M, Nagele T, Danz S, Ernemann U. Spinal pilocytic astrocytoma: MR imaging findings at first presentation and following surgery. Eur J Radiol. 2011;79(3):389–99.PubMedCrossRef
8.
Harraher CD, Vogel H, Steinberg GK. Spinal pilocytic astrocytoma in an elderly patient. World neurosurgery. 2013;79(5–6):799 E797–9.
9.
Bansal S, Borkar SA, Mahapatra AK. Hydrocephalus associated with spinal intramedullary pilocytic astrocytoma. Asian journal of neurosurgery. 2017;12(2):217–9.PubMedPubMedCentral
10.
Schittenhelm J, Ebner FH, Tatagiba M, Wolff M, Nagele T, Meyermann R, Mittelbronn M. Holocord pilocytic astrocytoma--case report and review of the literature. Clin Neurol Neurosurg. 2009;111(2):203–7.PubMedCrossRef
11.
12.
Larson DB, Hedlund GL. Non-enhancing pilocytic astrocytoma of the spinal cord. Pediatr Radiol. 2006;36(12):1312–5.PubMedCrossRef
13.
Kim DH, Kim JH, Choi SH, Sohn CH, Yun TJ, Kim CH, Chang KH. Differentiation between intramedullary spinal ependymoma and astrocytoma: comparative MRI analysis. Clin Radiol. 2014;69(1):29–35.PubMedCrossRef
14.
Koeller KK, Rosenblum RS, Morrison AL. Neoplasms of the spinal cord and filum terminale: radiologic-pathologic correlation. Radiographics. 2000;20(6):1721–49.PubMedCrossRef
15.
Fine MJ, Kricheff II, Freed D, Epstein FJ. Spinal cord ependymomas: MR imaging features. Radiology. 1995;197(3):655–8.PubMedCrossRef
16.
Minehan KJ, Brown PD, Scheithauer BW, Krauss WE, Wright MP. Prognosis and treatment of spinal cord astrocytoma. Int J Radiat Oncol Biol Phys. 2009;73(3):727–33.PubMedCrossRef
17.
18.
Milano MT, Johnson MD, Sul J, Mohile NA, Korones DN, Okunieff P, Walter KA. Primary spinal cord glioma: a surveillance, epidemiology, and end results database study. J Neuro-Oncol. 2010;98(1):83–92.CrossRef
19.
Bloomer CW, Ackerman A, Bhatia RG. Imaging for spine tumors and new applications. Top Magn Reson Imaging. 2006;17(2):69–87.PubMedCrossRef
20.
Do-Dai DD, Brooks MK, Goldkamp A, Erbay S, Bhadelia RA. Magnetic resonance imaging of intramedullary spinal cord lesions: a pictorial review. Curr Probl Diagn Radiol. 2010;39(4):160–85.PubMedCrossRef
21.
Xia J, Yin B, Liu L, Lu Y, Geng D, Tian W. Imaging features of Pilocytic astrocytoma in cerebral ventricles. Clin Neuroradiol. 2016;26(3):341–6.PubMedCrossRef
22.
Gaudino S, Martucci M, Russo R, Visconti E, Gangemi E, D'Argento F, Verdolotti T, Lauriola L, Colosimo C. MR imaging of brain pilocytic astrocytoma: beyond the stereotype of benign astrocytoma. Childs Nerv Syst. 2017;33(1):35–54.PubMedCrossRef
23.
Koeller KK, Rushing EJ. From the archives of the AFIP: pilocytic astrocytoma: radiologic-pathologic correlation. Radiographics. 2004;24(6):1693–708.PubMedCrossRef
24.
Seo HS, Kim JH, Lee DH, Lee YH, Suh SI, Kim SY, Na DG. Nonenhancing intramedullary astrocytomas and other MR imaging features: a retrospective study and systematic review. AJNR Am J Neuroradiol. 2010;31(3):498–503.PubMedCrossRefPubMedCentral
25.
Arima H, Hasegawa T, Togawa D, Yamato Y, Kobayashi S, Yasuda T, Matsuyama Y. Feasibility of a novel diagnostic chart of intramedullary spinal cord tumors in magnetic resonance imaging. Spinal Cord. 2014;52(10):769–73.PubMedCrossRef
26.
Samartzis D, Gillis CC, Shih P, O'Toole JE, Fessler RG. Intramedullary spinal cord tumors: part I-epidemiology, pathophysiology, and diagnosis. Global Spine J. 2015;5(5):425–35.PubMedPubMedCentralCrossRef
27.
Kobayashi K, Imagama S, Kato F, Kanemura T, Sato K, Kamiya M, Ando K, Ito K, Tsushima M, Matsumoto A, et al. MRI characteristics of spinal ependymoma in WHO grade II: a review of 59 cases. Spine (Phila Pa 1976). 2017.
28.
Beni-Adani L, Gomori M, Spektor S, Constantini S. Cyst wall enhancement in pilocytic astrocytoma: neoplastic or reactive phenomena. Pediatr Neurosurg. 2000;32(5):234–9.PubMedCrossRef
29.
Kumar AJ, Leeds NE, Kumar VA, Fuller GN, Lang FF, Milas Z, Weinberg JS, Ater JL, Sawaya R. Magnetic resonance imaging features of pilocytic astrocytoma of the brain mimicking high-grade gliomas. J Comput Assist Tomogr. 2010;34(4):601–11.PubMedCrossRef
30.
de Fatima Vasco Aragao M, Law M, Batista de Almeida D, Fatterpekar G, Delman B, Bader AS, Pelaez M, Fowkes M, Vieira de Mello R, Moraes Valenca M. Comparison of perfusion, diffusion, and MR spectroscopy between low-grade enhancing pilocytic astrocytomas and high-grade astrocytomas. AJNR Am J Neuroradiol. 2014;35(8):1495–502.PubMedCrossRefPubMedCentral
31.
Murakami R, Hirai T, Kitajima M, Fukuoka H, Toya R, Nakamura H, Kuratsu J, Yamashita Y. Magnetic resonance imaging of pilocytic astrocytomas: usefulness of the minimum apparent diffusion coefficient (ADC) value for differentiation from high-grade gliomas. Acta Radiol. 2008;49(4):462–7.PubMedCrossRef
32.
Crawford JR, Zaninovic A, Santi M, Rushing EJ, Olsen CH, Keating RF, Vezina G, Kadom N, Packer RJ. Primary spinal cord tumors of childhood: effects of clinical presentation, radiographic features, and pathology on survival. J Neuro-Oncol. 2009;95(2):259–69.CrossRef
33.
White JB, Piepgras DG, Scheithauer BW, Parisi JE. Rate of spontaneous hemorrhage in histologically proven cases of pilocytic astrocytoma. J Neurosurg. 2008;108(2):223–6.PubMedCrossRef
34.
Plank C, Koller A, Mueller-Mang C, Bammer R, Thurnher MM. Diffusion-weighted MR imaging (DWI) in the evaluation of epidural spinal lesions. Neuroradiology. 2007;49(12):977–85.PubMedCrossRef
35.
Vargas MI, Delavelle J, Jlassi H, Rilliet B, Viallon M, Becker CD, Lovblad KO. Clinical applications of diffusion tensor tractography of the spinal cord. Neuroradiology. 2008;50(1):25–9.PubMedCrossRef
36.
Gimi B, Cederberg K, Derinkuyu B, Gargan L, Koral KM, Bowers DC, Koral K. Utility of apparent diffusion coefficient ratios in distinguishing common pediatric cerebellar tumors. Acad Radiol. 2012;19(7):794–800.PubMedCrossRef
37.
Abd-El-Barr MM, Huang KT, Chi JH. Infiltrating spinal cord astrocytomas: epidemiology, diagnosis, treatments and future directions. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia. 2016;29:15–20.CrossRef
Metadata
Title
MR imaging features of spinal pilocytic astrocytoma
Authors
De-jun She
Yi-ping Lu
Ji Xiong
Dao-ying Geng
Bo Yin
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Medical Imaging / Issue 1/2019
Electronic ISSN: 1471-2342
DOI
https://doi.org/10.1186/s12880-018-0296-y

Other articles of this Issue 1/2019

BMC Medical Imaging 1/2019 Go to the issue

Research article

A comparative analysis of diffusion-weighted imaging and ultrasound in thyroid nodules

Research article

Clinical and imaging manifestations of primary cardiac angiosarcoma

Research article

Comparison of conventional and Si-photomultiplier-based PET systems for image quality and diagnostic performance

Research article

Assessment the reliability of ultrasonography in the imaging of the plantar fascia: a comparative study

Research article

The routes of infection spread in central skull-base osteomyelitis and the diagnostic role of CT and MRI scans

Research article

Combination of CEUS and MRI for the diagnosis of periampullary space-occupying lesions: a retrospective analysis