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Spinal Epidural Masses: MR Imaging Features with Surgical and Pathologic Correlation 2013

Category General Spine Jaewon Jung
So Young Kim Sr.
Joon Woo Lee Sr.
Purpose 1) A veriety of disorders may occur in the epidual space. 2) the majority of epidural masses arise from vertebrae and intervertebral discs. 3) the lesion located the epidural space without vertebral involvement are rare, except herniated discs. 4) We present the MR imaging features, operative findings with pictures or video clips, and pathologic findings of a variety of spinal epidural masses. Materials & Methods 1) We searched for patients with spinal epidural mess on MR images in the data base of our educational institutions. 2) Case study using the data of the patient. Results Content organization 1) The cases will be presented in a quiz format. 2) Brief review will be accompanied in the discussion of each case. The list of cases includes: Tumors: Hemangioma, Lymphoma, Myeloid sarcoma,Teratoma, Chondroma, Cysts and other tumor-like masses: Epidural lipomatosis, Extradural arachnoid cyst, Synovial cyst, Perineural cyst, Sequestered disc, Conjoined nerve root, Epidural hematoma, Epidural abscess Miscellaneous: Pachymeningitis due to Wegener’s granulomatosis (mistaken as epidural tumor)The radiologists should be familiar with the MR imaging features of a variety of epidural lesions.  Conclusion The radiologists should be familiar with the MR imaging features of a variety of epidural lesions. References 1. Lee JW, Cho EY, Hong SH, et al. Spinal epidural hemangiomas: various types of MR imaging features with histopathologic correlation. AJNR Am J Neuroradiol 2007;28:1242-1248 2. Leu NH, Chen SC, Chou JM. MR features of posterior spinal epidural cavernous hemangioma: a case report. Chin J Radiol 2006;31:127-131 3. Mascalchi M, Torselli P, Falaschi F, Pozzo GD. MRI of the spinal epidural lymphoma. Neuroradiology 1995;37:303-307 4. Li MH, Holtas S, Larsson EM. MR imaging of spinal lymphoma. Acta Radiol 1992;33:338-342 5. Liou DC, Chou JM. MRI of primary spinal epidural lymphoma: case report. Chin J Radiol 2007;32:147-151 6. Guermazi A, Feger C, Rousselot P, et al. Granulocytic sarcoma (chloroma). AJR Am J Roentgenol 2002;178:319-325 7. Mostafavi H, Lennarson PJ, Traynelis VC. Granulocytic sarcoma of the spine. Neurosurgery 2000;46:78-83 8. Verra WC, Snijders TJ, Seute T, et al. Myeloid sarcoma presenting as a recurrent, multifocal nerve root entrapment syndrome. J Neurooncol 2009;91:59-62 10. Grimme JD, Castillo M. Congenital anomalies of the spine. Neuroimag Clin N Am 2007;17:1-16 11. Ueno T, Tanaka YO, Nagata M, et al. Spectrum of germ cell tumors: from head to toe. Radiographics 2004;24:387-404 12. Tureyen K, Senol N, Sahin B, et al. Spinal extradural arachnoid cyst. Spine J 2009;9:e10-e15 13. Braun P, Kazmi K, Nogues-Melendez P, et al. MRI findnigs in spnial subdural and epidural hematomas. Eur J Radiol 2007;64:119-125 14. Munday TL, Johnson MH, Hayes CW, et al. Radiographics 1994;14:1225-1245