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Differentiating between spinal schwannomas and meningiomas using MRI: A focus on cystic change.

ABSTRACT: OBJECTIVES:To retrospectively determine the diagnostic ability of MRI in differentiating between intradural extramedullary spinal schwannomas and meningiomas. METHODS:A total of 199 patients with spinal intradural extramedullary tumors who underwent preoperative contrast-enhanced MRI between January 2012 and December 2018 were included in this study. Two radiologists independently analyzed the presence of cystic change, dural tail sign, and neural foraminal extension. Clinical and MRI features between the two groups were compared by univariable and multivariable analyses using logistic regression. Interobserver agreements were calculated using kappa statistics. RESULTS:Patients with schwannoma showed significantly higher frequency of cystic change (96% vs 24%, P < 0.001), neural foraminal extension (29% vs 3%, P = 0.001), and lumbar location (41% vs 5%, P = 0.008). Patients with meningioma showed significantly higher frequency of dural tail sign (64% vs 1%, P < 0.001), thoracic location (75% vs 31%, P = 0.007), older age (59.7 years vs 47.6 years, P < 0.001), higher female predominance (83% vs 50%, P < 0.001), and smaller size (19.8 cm vs 28.8 cm, P < 0.001). Multivariable analysis showed that cystic change (P < 0.001; odds ratio [OR], 0.02), dural tail sign (P < 0.001; OR, 36.23), age (P = 0.032; OR, 1.06), and lumbar location (P = 0.006; OR, 0.02) were independent factors. Interobserver agreements were almost perfect for all analyses. CONCLUSIONS:MRI features were useful in differentiating between intradural extramedullary schwannomas from meningiomas. The presence of cystic change and dural tail sign were independently significant discriminators.

SUBMITTER: Lee JH

PROVIDER: S-EPMC7259580 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Differentiating between spinal schwannomas and meningiomas using MRI: A focus on cystic change.

Lee Ji Hyun JH Kim Hyun Su HS Yoon Young Cheol YC Cha Min Jae MJ Lee Sun-Ho SH Kim Eun-Sang ES

PloS one 20200529 5

<h4>Objectives</h4>To retrospectively determine the diagnostic ability of MRI in differentiating between intradural extramedullary spinal schwannomas and meningiomas.<h4>Methods</h4>A total of 199 patients with spinal intradural extramedullary tumors who underwent preoperative contrast-enhanced MRI between January 2012 and December 2018 were included in this study. Two radiologists independently analyzed the presence of cystic change, dural tail sign, and neural foraminal extension. Clinical and ...[more]

PMID: 32469953

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Project description:BackgroundSpinal metastasis and multiple myeloma share many overlapping conventional radiographic imaging characteristics, thus, their differentiation may be challenging. The purpose of this study was to develop and validate an MRI-based radiomics nomogram for the differentiation of spinal metastasis and multiple myeloma.Materials and methodsA total of 312 patients (training set: n = 146, validation set: n = 65, our center; external test set: n = 101, two other centers) with spinal metastasis (n = 196) and multiple myeloma (n = 116) were retrospectively enrolled. Demographics and MRI findings were assessed to build a clinical factor model. Radiomics features were extracted from MRI images. A radiomics model was constructed by the least absolute shrinkage and selection operator method. A radiomics nomogram combining the radiomics signature and independent clinical factors was constructed. And, one experienced radiologist reviewed the MRI images for all case. The diagnostic performance of the different models was evaluated by receiver operating characteristic curves.ResultsA clinical factors model was built based on heterogeneous appearance and shape. Twenty-one features were used to build the radiomics signature. The area under the curve (AUC) values of the radiomics nomogram (0.853 and 0.762, respectively) were significantly higher than that of the clinical factor model (0.692 and 0.540, respectively) in both validation (p = 0.048) and external test (p < 0.001) sets. The AUC values of the radiomics nomogram model were higher than that of radiologist in training, validation and external test sets (all p < 0.05). Moreover, no significant difference in AUC values of radiomics nomogram model was found between the validation set and external test set (p = 0.212).ConclusionThe radiomics nomogram can differentiate spinal metastasis and multiple myeloma with a moderate to good performance, and may be as a valuable method to assist in the clinical diagnosis and preoperative decision-making.

Dataset Information

Differentiating between spinal schwannomas and meningiomas using MRI: A focus on cystic change.

Publications

Differentiating between spinal schwannomas and meningiomas using MRI: A focus on cystic change.

Similar Datasets

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