Imaging diagnosis and the role of endovascular embolization treatment for vascular intraspinal tumors

Neurosurg Focus. 2015 Aug;39(2):E16. doi: 10.3171/2015.5.FOCUS1514.

Abstract

Intraspinal tumors comprise a large spectrum of neoplasms, including hemangioblastomas, paragangliomas, and meningiomas. These tumors have several common characteristic imaging features, such as highly vascular mass appearance in angiography, hypointense rim and serpentine flow voids in MRI, and intense enhancement after intravenous contrast administration. Due to their rich vascularity, these tumors represent a special challenge for surgical treatment. More recently, the surgical treatment of intraspinal vascular tumors has benefited from the combination of endovascular techniques used to better delineate these lesions and to promote preoperative reduction of volume and tissue blood flow. Endovascular embolization has been proven to be a safe procedure that facilitates the resection of these tumors; hence, it has been proposed as part of the standard of care in their management.

Keywords: CSF = cerebrospinal fluid; CT = computed tomography; CTA = CT angiography; DSA = digital subtraction angiography; DTI = diffusion tensor tractography; Lindau; MIP = maximum intensity projection; MR = magnetic resonance; MRA = MR angiography; MRI = MR imaging; MRS = MR spectroscopy; NBCA = N-butyl cyanoacrylate; PVA = polyvinyl alcohol; VHL = von Hippel; diagnosis; embolization; hemangioblastoma; meningioma; paraganglioma; spinal; surgery; vascular.

Publication types

  • Review

MeSH terms

  • Angiography
  • Embolization, Therapeutic / methods*
  • Hemangioblastoma / therapy
  • Humans
  • Magnetic Resonance Imaging*
  • Meningioma / therapy
  • Paraganglioma / therapy
  • Spinal Cord / blood supply*
  • Spinal Cord Neoplasms / diagnostic imaging
  • Spinal Cord Neoplasms / pathology*
  • Spinal Cord Neoplasms / therapy*