Retrospective evaluation of MR images of nine intraspinal dermoid (n =
4) and epidermoid (n = 5) tumours was undertaken. T1-weighted images
were available in all the patients while proton density (PD) and T2-we
ighted images were available in seven patients. Except for one lesion
(only T1-weighted images were available in this case), all the lesions
were clearly delineated on MR images. Most (5 out of 7) were better a
ppreciated on T1- and PD-weighted images than on T2-weighted images. O
n T1-weighted images, the epidermoids were either iso- to mildly hypoi
ntense to the cord (n = 3), isointense to CSF (n = 1) or markedly hype
rintense (n = 1). On the PD images, the epidermoids were either isoint
ense to cord (n = 3) or markedly hyperintense (n = 1). All the lesions
were iso- to hyperintense to CSF on T2-weighted images. Of the four d
ermoids three showed a mixed intensity pattern on all sequences; the d
ominant component gave short Tl and short T2 values, consistent with f
at. The fourth lesion showed homogenous material with a signal intensi
ty intermediate between that of CSF and cord on T1-weighted images. De
rmal sinus tracts were present in four of the nine patients; three pat
ients had an intraspinal component. This study shows that although MR
imaging is excellent for their detection, it cannot differentiate the
two tumour types.