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53 Cards in this Set
- Front
- Back
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What % of pt with HIV have vacuolar myelopathy at autopsy
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30%
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On T2 what is darker the vetebral body or the disc
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disc
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If a pt was on broad spectrum ABX for 3 weeks what is the chance of recovering an organism form biopsy
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almost 0%
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Is a neurofibroma benign
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yes
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What are the MC metastasis to the spine
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breast
lung prostate |
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What are the 3 locations of a tumor
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extradural
intradural/extramedullary intradural/intramedullary (in spinal cord) |
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What is the appearance of intradural/intramedullary
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cord widened in all views
CSF space thinned on all sides |
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What is the DDX for intramedullary/intradural
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ependymoma
astrocystoma hemangioblastoma lipoma (also extramedullary) dermoid (also extramedullary) syringohydromyelia intramedullary AVM mets/abscess (rare) |
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What are the characteristics of intradural/extramedullary
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marble on the carpet appearance
cord widened on lateral view CSF space thinned on one side and may be wider on other side |
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What is the DDX of intradural/extramedullary
10 |
meningioma
schwannoma neurofibroma (the last 3 are also all seen in NF2 and also bilat acoustic neuromas) hemangiopericytoma lipoma (also intramedullary) dermoid (also intramedullary) arachnoid cyst adhesion leptomeningeal mets extramedullarary AVM |
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What are the characteristics of an extradural lesion
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marble under the carpet appearance
dura and thecal sac displaced together CSF thinned on all sides cord may be wide in one plane |
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What is the most common cause of an extradural lesion
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herniated disc
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What is the DDX of degenerative causes of extradural lesions
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herniated disc
synovial cyst osteophyte rheumatoid pannus |
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What is the DDX of non-degenerative extradural lesions
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mets
abscess hematoma epidural lipomatosis primary tumor expansion or invasion |
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What is the thecal sac
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The thecal sac is a membrane of dura mater that surrounds the spinal cord and the cauda equina. This thecal sac is filed with cerebral spinal fluid.
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What interface does myelography clearly define
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exact definition of CSF space and bone
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What is a major reason to do a CT myelogram over MR
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pacemaker
defibrillators spinal metal instrumentation |
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What population of pts is a myelogram most useful for
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Pt with surgery and have spinal screws with metal and MR is not possible
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What is the maximum amount of iodine that can be given
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3 grams
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What should always be done when giving a pt contrast
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always look at the bottle and verify that it is correct
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What are the 3 MC primary neoplasms of the adult population
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neural orgin (schwannoma) 29%
Meninigiomas 25% Intramedullary (see previous ddx) (33%) |
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What composes the 23 % of remaining tumors in adults
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sarcoma
vascular tumors chordomas intraspinal mets (vetebral mets/ epidural mets) |
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What are the 3 MC spinal neoplasm of children
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developmental (38%)
primary neural neoplasm (30%) CSF Mets (10) |
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What tumors make up developmental tumors
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teratoma
dermoid lipoma syringohydromyelia (chiari 10 neurenteric cyst intraspinal meningoceles |
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Do children typically get meningiomas
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no
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What is the ddx of intramedullary disease
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pirmary glial (astrocytoma, ependymoma)
demyelination viral myelitis vascular malformation congenital mass hematoma/edema |
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What are two causes of demyelination
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MS
ADEM |
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What is an example of a 'congenital mass'
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syrinx (dilatation of CSF space)
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What happens to the vetebral bodies following radiation therapy on T1
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fatty and bright
stunting of growth in pediatric children |
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What is the ddx of malignant spine tumors
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astrocytoma, glioblastoma, oligodendroglioma, medulloblastoma ependymoma
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What are 3 primary benign tumors
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neurofibroma, schwannoma, meningioma
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What are the 3 MC mets to the spine
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breast, prostate, lung
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What are 3 myeloproliferative disorders
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leukemia, lymphoma, myeloma
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What do astrocytomas and ependymomas look like on T1 and T2
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intramedullary
T1-hypointense T2-hyperintense |
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Can you differentiate an astrocytoma and ependymoma on imaging
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no, but ependymomas tend to be more centrally located
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What tumors tend to arise from the center of the spinal cord
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ependymoma, arise centrally from ependymal cells
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What type of ependymoma arise at the tip of the conus medularis
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myxopapillary ependymoma
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t
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t
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What is the ddx of a conus tumor
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schwannoma, meningioma, drop mets
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What is disease is hemangioblastoma associated with
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VHL
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What are the causes extramedullary-intramedullary tumroms
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meningioma
schwannoma neurofibroma drop mets mets non-cns infectious meningitis |
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What are 3 examples of primary tumors that are extramedullary-intramedullary
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meningioma, schwannoma, neurofibroma
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What are 3 examples of CSF based drop mets
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astrocytoma
ependymoma PNET |
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Can infectious meningitis cause extramedullary-intramedullary lesions
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yes
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What type of shaped lesion does a schwannoma typically form
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dumbell shaped lesion
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How do you determine if a pt has neurofibroma or a shwannoma
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the age of the pt, if the pt does not have NF than its a schwannoma
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What is the enhancement of a schwannoma
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variable enhancement
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On axial imaging of the spine where does a schwannoma typically lead
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the neuroforamen
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can a pt have a central area of hypodensity on post gad imaging of a schwannoma
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yes, indicating a central area of necrosis which occasionally will occur
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What are 3 characteristics of a meningioma of the spine
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broad dural base
dense enhancement no foraminal extension |
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Does a meningioma and a schwannoma both enhance
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yes
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Is it possible to have neurofibromas at almost every level
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yes in NF 1
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What is the MC spinal tumor
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mets
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