Spinal lesions

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  • Ependymoma - most common lesion in adults, arise from ependymal lining on central canal, 44% cervical, T1 iso to hypointense, T2 hyperintense, intense enhancement, may contain a hemosiderin cap.
    • Myxopapillary ependymoma - arise in filum terminale, enhancing components, can have mucinous or hemorrhagic components
  • Astrocytoma - most common in children, second most common in adults, ececentric, commonly a low grade glioma unlike in brain where more often high grade, often more invasive than ependymoma, T1 hypointense, T2 hyperintense, varied enhancement patterns.
  • Hemangioblastoma - 60% intramedullary, a/w von Hipple Lindau, T1 isointense, T2 heterogeneous hyperintense, heterogeneous enhancement with flow voids possible.
  • Multiple sclerosis - T1 isointense, T2 hyperintense.
  • Syringohydromyelia - think hydrocephalus of the central canal (different from syringomyelia which is a tear in ependyma).
  • Metastasis


  • Meningioma - T1 and T2 isointense, intense enhancement
  • Schwannoma - most common, a/w NF2, encapsulated, T1 iso, T2 hyper, hyperenhance, can contain fat or hemorrhage
  • Neurofibroma - a/w NF2, T1 iso to hypo, T2 hyper with central hypo (target sign), enhance
  • Paraganglioma - rare, T1 hypo, T2 hyper, salt and pepper on T2, variable enhancement


  • Abscess
  • Hematoma