INTRADURAL EXTRAMEDULLARY SPINAL-CANAL SECONDARY NEOPLASMS - MR FINDINGS IN 30 PATIENTS

The purpose of this study was to describe magnetic resonance findings of intradural spinal canal secondaries and to select the best way to i nvestigating this condition. Thirty patients with a known malignancy [ breast carcinoma (n = 14), lung carcinoma ( n = 10), other sites (n = 6)] and unexplained neurological signs were studied with pre- and post -contrast T1-weighted images and T2-weighted images. Cerebrospinal flu id cytology was available in 16 patients and positive in 11 patients. In all the patients, post-contrast T1-weighted images demonstrated abn ormal enhanced lesions. Most of them were nodular, located on the conu s medullaris and the cauda equina. Few lesions appeared at the thoraci c or cervical levels, as nodular or thin areas of enhancement. Pre-con trast T1-weighted sequences failed or were equivocal to detect the les ions. Eighteen of 30 patients had cerebral metastases. Fourteen had os seous metastases. In conclusion, post-contrast T1-weighted sequence is the optimal modality for the diagnostic of intradural spinal canal me tastases. Axial and coronal images may be a useful adjunct to precise anatomic changes. T1-weighted and T2-weighted sequences remain necessa ry when further information is expected on vertebra or soft tissue.