Contrast MRI Findings for Spinal Schwannoma as Predictors of Tumor Proliferation and Motor Status. Issue 3 (February 2017)

• Record Type: Journal Article
• Authors: Kobayashi, Kazuyoshi; Imagama, Shiro; Ando, Kei; Hida, Tetsuro; Ito, Kenyu; Tsushima, Mikito; Ishikawa, Yoshimoto; Matsumoto, Akiyuki; Morozumi, Masayoshi; Tanaka, Satoshi; Ishiguro, Naoki
• Is Part Of: Spine. Volume 42:Issue 3(2017)
• Page Start: E150
• Page End: E155
• Publication Date: 2017-02
• Subjects: contrast MRI -- heterogeneous intensity -- MIB-1 index -- motor status -- spinal schwannoma; Spine -- Abnormalities -- Periodicals; Spine -- Diseases -- Periodicals; Spine -- Surgery -- Periodicals; 616.73005
• DOI: 10.1097/BRS.0000000000001732
• Languages: English
• ISSNs: 0362-2436

Abstract

Abstract : Study Design: Retrospective analysis. Objective: The goal of this study was to examine the relationship of the proliferation potency based on the MIB-1 index and motor status with features of T2-weighted images (T2WI) and contrast T1-weighted images (T1WI) of spinal schwannoma. Summary of Background Data: Spinal schwannomas account for 55% of spinal tumors, but the relationship of cellular proliferation with MRI findings for spinal schwannoma is unknown. Methods: The subjects were 48 patients (22 males and 26 females) with spinal schwannoma who were classified into three subgroups: iso/homo, high/rim, and hetero/hetero, based on T2WI/contrast T1WI. A retrospective analysis of tumor size and MIB-1 index was performed in the context of these MRI findings. Intraoperative findings and pre- and postoperative motor performance were also examined. Results: The average tumor size was 32.4 mm (range 10–130 mm) and the average MIB-1 index was 3.8% (range 1–12). In the three subgroups, there were no significant differences in sex, age, duration of disease, tumor lesion, and dumbbell type. In the hetero/hetero group, the tumor size was significantly greater and the MIB-1 index was significantly higher (both P < 0.05), than the other two groups. The tumor adherence rate was significantly higher for hetero tumors ( P < 0.05) and preoperative paralysis was more common in cases with tumor adhesion. The rate of paralysis improvement at 1 month was significantly lower for hetero tumors, but all cases had improved at 6 months. Conclusion: Contrast T1WI MRI was useful for prediction of the proliferative activity and growth of spinal schwannomas, which are associated with increased tumor size and adhesion. A heterogeneous pattern on contrast T1WI indicated an increase in size and adhesion of the tumor. This pattern reflected the preoperative motor status and postoperative motor recovery. Level of Evidence: 4