Differentiation between Intramedullary Spinal Cord Tumors and Multiple Sclerosis on Targeted T1-weighted Magnetic Resonance Imaging

In patients presenting with acute transverse myelopathy, it is clinically important to differentiate between intramedullary tumor and multiple sclerosis (MS) before deciding on a therapeutic strategy. However, it is sometimes difficult to differentiate between these two disorders on magnetic resonance (MR) imaging because they often show hyperintensity on T2-weighted images and isointensity on T1-weighted images. In these cases, radiological findings on T1-weighted images provide little useful information for the differential diagnosis. Therefore, in this study isointense images on T1-weighted imaging were reevaluated by changing and adjusting the window-level and -width focused on the intramedullary region of interest. The demarcation of the lesions became apparent in patients with intramedullary tumors, whereas similar findings were not observed in patients with multiple sclerosis. We emphasize that changes of window-level and width focused on the region of interest provides us additional information about the spinal cord that can not be obtained with the conventional MR imaging.

intramedullary spinal cord tumor

multiple sclerosis

magnetic resonance imaging