MRI of Spinal Neurofibroma
Neurofibroma is a type of tumor that develops from the nerve tissue. It’s a condition often associated with neurofibromatosis, a genetic disorder that causes tumors to form on nerve tissue. These tumors are usually benign (non-cancerous) but can occasionally become malignant (cancerous).
Symptoms of spinal neurofibroma vary depending on the size and location of the tumor. Common symptoms include:
- Pain: Often the first symptom, due to the tumor pressing on nerves or the spinal cord.
- Neurological Issues: Including numbness, weakness, or loss of function in the arms or legs.
- Changes in Bowel or Bladder Function: Resulting from pressure on the spinal cord.
Treatment options for spinal neurofibroma depend on the size, location, and symptoms caused by the tumor:
- Monitoring: Small, asymptomatic tumors may only require regular monitoring with imaging tests.
- Surgery: In cases where the tumor is causing significant symptoms or neurological deficits, surgical removal is often recommended. However, complete removal can be challenging due to the tumor’s location and its involvement with nerve tissues.
- Radiation Therapy: This may be used in some cases, although it’s less common due to the risk of further complications.
MRI Appearance of Spinal Neurofibroma
T1-Weighted Imaging: On T1 sequences, neurofibromas are usually isointense or slightly hypointense compared to the spinal cord. This means they have a similar or slightly darker signal intensity compared to the normal spinal cord tissue.
T2-Weighted Imaging: In T2 sequences, these tumors generally appear hyperintense, meaning they are brighter compared to the spinal cord. This is due to their high water content. However, the presence of dense collagen can make parts of the tumor appear hypointense or darker.
STIR (Short Tau Inversion Recovery): In STIR imaging, spinal neurofibromas are typically hyperintense. This sequence is particularly useful in suppressing fat signals, which helps in highlighting lesions like neurofibromas against the surrounding tissue.
T1 with Fat Saturation Post Contrast: After the administration of contrast material, neurofibromas usually enhance on T1-weighted images with fat saturation. This enhancement is often seen as a bright signal on the tumor, distinguishing it from the surrounding tissues. Fat saturation helps in reducing the signal from fatty tissues, making the enhanced tumor more conspicuous.
T2 sagittal image shows Spinal Neurofibroma
STIR sagittal image shows Spinal Neurofibroma
T1 TSE sagittal image shows Spinal Neurofibroma
T2 TSE axial image shows Spinal Neurofibroma
Post-contrast T1 fat saturation sagittal image shows Spinal Neurofibroma
Post-contrast T1 fat saturation axial image shows Spinal Neurofibroma
- Mauda-Havakuk, M., Shofty, B., Ben-Shachar, S., Ben-Sira, L., Constantini, S., & Bokstein, F. (2017). Spinal and Paraspinal Plexiform Neurofibromas in Patients with Neurofibromatosis Type 1: A Novel Scoring System for Radiological-Clinical Correlation. AJNR Am J Neuroradiol, 38(10), 1869–1875. doi: 10.3174/ajnr.A5338. PMC ID: PMC7963632. PMID: 28798215.
- Well, L., Careddu, A., Stark, M., Farschtschi, S., Bannas, P., Adam, G., Mautner, V.-F., & Salamon, J. (2021). Phenotyping spinal abnormalities in patients with Neurofibromatosis type 1 using whole-body MRI. Scientific Reports, 11, 16889. doi:10.1038/s41598-021-96279-2
- Mautner, V.-F., Tatagiba, M., Lindenau, M., Fünsterer, C., Pulst, S. M., Kluwe, L., & Zanella, F. E. (1995). Spinal Tumors in Patients with Neurofibromatosis Type 2: MR Imaging Study of Frequency, Multiplicity, and Variety. American Journal of Roentgenology, 165(4), 951.
- Mauda-Havakuk, M., Shofty, B., Ben-Shachar, S., Ben-Sira, L., Constantini, S., & Bokstein, F. (2017). Spinal and Paraspinal Plexiform Neurofibromas in Patients with Neurofibromatosis Type 1: A Novel Scoring System for Radiological-Clinical Correlation. American Journal of Neuroradiology, 38(10), 1869-1875. DOI: https://doi.org/10.3174/ajnr.A5338.