caa a22 4500 44583420X CHVBK 20180317145325.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1007/s00586-011-1814-6 doi (NATIONALLICENCE)springer-10.1007/s00586-011-1814-6 Differentiation of localization of spinal hemangioblastomas based on imaging and pathological findings [Elektronische Daten] [Shiro Imagama, Zenya Ito, Norimitsu Wakao, Yoshihito Sakai, Fumihiko Kato, Yasutsugu Yukawa, Koji Sato, Kei Ando, Kenichi Hirano, Ryoji Tauchi, Akio Muramoto, Yoshio Hashizume, Yukihiro Matsuyama, Naoki Ishiguro] Intramedullary+extramedullary hemangioblastomas with largely extramedullary growth are rare and often incorrectly assigned as intradural-extramedullary tumors preoperatively. Preoperative evaluation of the precise tumor location is important for total resection of tumor and improving the surgical outcome. The aim of this study was to provide the first identification of the key differences among of preoperative MR images of hemangioblastomas in different locations and to correlate these with pathological findings. The subjects were 26 patients with surgery for spinal hemangioblastoma in our department, including 6 with an intramedullary tumor who were complicated with von Hippel Lindau disease. Intramedullary, intramedullary+extramedullary, and intradural-extramedullary tumors were present in 22, 3 and 1 cases, respectively. Sagittal MR images showed that intramedullary and intramedullary+extramedullary tumors gave intramedullary T2 high intensity areas (HIAs) spreading toward the craniocaudal sides of the tumor, whereas such findings were absent for the intradural-extramedullary tumor. All the tumors showed strong contrast on axial images, with focal enhancement of hemangioblastomas limited to the intramedullary region (focal type); smooth boundary lines between the spinal cord and the extramedullary tumor (smooth type); and a snowman sign for intramedullary+extramedullary tumors, which provided a key characteristic for differentiating intramedullary+extramedullary tumors from those limited to the extramedullary region. In pathological findings, the Ki67 activity was less than 1% for intramedullary and intradural-extramedullary tumors, but 18-25% in all cases with an intramedullary+extramedullary tumor. In conclusion, on preoperative MRI, a change in the intramedullary HIAs spreading the craniocaudal sides of the tumor on sagittal T2 weighted image (T2WI) and a snowman sign on contrast axial T1WI may be important for differentiation among spinal hemangioblastomas in different locations. Pathologically, we found that intramedullary+extramedullary hemangioblastoma has high cell proliferative activity, which may suggest that enlargement of this tumor occurs faster than that of intramedullary hemangioblastoma. Springer-Verlag, 2011 Spinal hemangioblastoma nationallicence Exophytic intramedullary hemangioblastoma nationallicence Differentiation of localization nationallicence MRI findings nationallicence Pathological findings nationallicence Imagama Shiro Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, Japan aut Ito Zenya Department of Orthopaedic Surgery, Toyohashi Municipal Hospital, 50 Hachikennishi, Aotake-cho, 441-8570, Toyohashi, Aichi, Japan aut Wakao Norimitsu Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, Japan aut Sakai Yoshihito Department of Orthopaedic Surgery, National Center for Geriatrics and Gerontology, Gengo 36-3, Morioka-cho, 474-8511, Obu, Aichi, Japan aut Kato Fumihiko Department of Orthopaedic Surgery, Chubu Rosai Hospital, 1-10-6 Koumei, Minato-ku, 455-8530, Nagoya, Aichi, Japan aut Yukawa Yasutsugu Department of Orthopaedic Surgery, Chubu Rosai Hospital, 1-10-6 Koumei, Minato-ku, 455-8530, Nagoya, Aichi, Japan aut Sato Koji Department of Orthopaedic Surgery, Nagoya Daini Red Cross Hospital, 2-9 Myoken-cho, Showa-ku, 466-8650, Nagoya, Aichi, Japan aut Ando Kei Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, Japan aut Hirano Kenichi Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, Japan aut Tauchi Ryoji Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, Japan aut Muramoto Akio Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, Japan aut Hashizume Yoshio Institute for Medical Science of Aging, Aichi Medical University, Nagakute-cho, 480-1195, Aichigun, Aichi, Japan aut Matsuyama Yukihiro Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, 431-3192, Hamamatsu, Shizuoka, Japan aut Ishiguro Naoki Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, Japan aut European Spine Journal Springer-Verlag 20/8(2011-08-01), 1377-1384 0940-6719 20:8<1377 2011 20 586 https://doi.org/10.1007/s00586-011-1814-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-011-1814-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Imagama Shiro Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Ito Zenya Department of Orthopaedic Surgery, Toyohashi Municipal Hospital, 50 Hachikennishi, Aotake-cho, 441-8570, Toyohashi, Aichi, Japan aut NATIONALLICENCE 700 1- Wakao Norimitsu Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Sakai Yoshihito Department of Orthopaedic Surgery, National Center for Geriatrics and Gerontology, Gengo 36-3, Morioka-cho, 474-8511, Obu, Aichi, Japan aut NATIONALLICENCE 700 1- Kato Fumihiko Department of Orthopaedic Surgery, Chubu Rosai Hospital, 1-10-6 Koumei, Minato-ku, 455-8530, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Yukawa Yasutsugu Department of Orthopaedic Surgery, Chubu Rosai Hospital, 1-10-6 Koumei, Minato-ku, 455-8530, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Sato Koji Department of Orthopaedic Surgery, Nagoya Daini Red Cross Hospital, 2-9 Myoken-cho, Showa-ku, 466-8650, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Ando Kei Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Hirano Kenichi Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Tauchi Ryoji Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Muramoto Akio Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, Japan aut NATIONALLICENCE 700 1- Hashizume Yoshio Institute for Medical Science of Aging, Aichi Medical University, Nagakute-cho, 480-1195, Aichigun, Aichi, Japan aut NATIONALLICENCE 700 1- Matsuyama Yukihiro Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, 431-3192, Hamamatsu, Shizuoka, Japan aut NATIONALLICENCE 700 1- Ishiguro Naoki Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi, Japan aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20/8(2011-08-01), 1377-1384 0940-6719 20:8<1377 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer