![]() Vertebral venous vascular malformation, formerly known as hemangioma as it was thought to be a vascular tumor, is the most common benign lesion of the spine in adults. Vertebral venous vascular malformation (formerly known as hemangioma) MRI is critical in identifying the anatomic location and soft tissue extent of all spinal tumors. MRI offers superior soft tissue contrast over CT, which allows better characterization of intervertebral discs, vertebral marrow, and contents of the spinal canal. It has the advantage of not requiring radiation exposure and provides better contrast details. MRI is preferred when neurologic symptoms are present. CT is also more rapidly acquired compared to MRI, therefore more favored in the acute setting. CT allows for better visualization of facet degenerative changes and fractures, particularly of the posterior elements. ĬT provides superior cortical bony details compared to MRI and is helpful in tumor matrix characterization. ĬT and MRI are advanced cross-sectional imaging modalities and more favorable for patients with more severe symptoms, neurologic deficits, or if there is suspicion of severe underlying conditions such as infection, cauda equina involvement, or cancer with spinal cord extension. Radiographs are helpful in the evaluation of fractures, degenerative changes, disc, and vertebral body height, as well as assessment for bony density and architecture. They are the most commonly ordered spinal imaging test due to their ready availability and low cost. Familiarity with the characteristic imaging features can help the radiologist reach an accurate diagnosis and obviate the need for unnecessary invasive procedures such as biopsy and surgery.Īlthough most cases of mechanical low back pain resolve with conservative treatment, radiographs are often obtained as initial screening studies. The article also includes other less-encountered primary spinal tumors such as plasmacytoma, osteoid osteoma, osteoblastoma, giant cell tumor, eosinophilic granuloma, chordoma, chondrosarcoma, osteosarcoma, Ewing’s sarcoma, and angiosarcoma. The discussion includes the commonly encountered benign lesions, such as vertebral venous vascular malformation and enostosis, as well as malignant lesions including metastases and lymphoma. This article focuses on the spectrum of extradural spinal tumors, accounting for the majority of primary spinal tumors, by comparing the epidemiology, pathophysiology, clinical presentation, and characteristic imaging appearance of these lesions. Familiarity with the range of benign and malignant spinal pathology can help the radiologist formulate a comprehensive differential diagnosis. Spinal osseous neoplasms are frequently encountered and can be challenging when present as solitary lesions. ![]()
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