MR findings in spinal hemangioblastoma: Correlation with symptoms and withangiographic and surgical findings

BACKGROUND AND PURPOSE: To our knowledge, a detailed analysis of MR finding s in spinal hemangioblastoma has not been conducted to date. Our purpose wa s to elucidate the MR features of this disease with special attention to tu mor size, correlation with MR findings and clinical symptoms, and any diffe rences between patients with and without von Hippel-Lindau disease (VHLD). METHODS: MR images in five patients with VHLD and seven patients without VH LD were reviewed retrospectively for spinal hemangioblastoma by two neurora diologists, The MR findings were correlated with clinical symptoms and with angiographic and surgical findings. RESULTS: The MR features depended on the size of the spinal hemangioblastom a, Small (10 mm or less) hemangioblastomas were mostly isointense on T1-wei ghted images, hyperintense on T2-weighted images, and showed homogeneous en hancement. Larger hemangioblastomas tended to be hypointense or mixed hypo- and isointense on T1-weighted images, heterogeneous on T2-weighted images, and tended to show heterogeneous enhancement. Small hemangioblastomas were located at the surface of the spinal cord, most frequently along its poste rior aspect. These were subpial in location at surgery and showed well-dema rcated, intense enhancement. Symptomatic small hemangioblastomas had relati vely large associated syringes, whereas asymptomatic ones did not. A hemang ioblastoma larger than 24 mm was invariably accompanied by vascular flow vo ids. There was no difference in the MR findings between the two patient gro ups except for the multiplicity and higher percentage of small tumors in pa tients with VHLD. CONCLUSION: Knowledge of these MR features helps to differentiate spinal he mangioblastoma from other diseases that show enhancing nodules.