PEDIATRIC SPINAL NEOPLASMS

Magnetic resonance imaging (MRI) is an accurate and noninvasive tool i n the evaluation of children with spinal neoplasm. Localization and de finition of site and extent of disease for treatment planning, the mos t important goals of neuroimaging in spinal neoplastic disease, have b ecome more precise with MRI, because all spinal compartments can be se en without the need for subarachnoid puncture. Epidural and contiguous soft tissue disease, and associated vertebral abnormalities such as m arrow replacement by metastatic processes, are readily confirmed durin g the same examination. In children, as in adults, gadolinium-diethyle netriaminepentaacetic acid aids in separating intramedullary neoplasms from associated edema or syrinx, and is essential in the evaluation o f intradural-extramedullary spread of neoplasm. MRI is also useful in the exclusion of compressive lesions in children with systemic neoplas ms and cord infarction or treatment-related transverse myelopathy.