1. Abstract Id: IRIA- 1035

2. INTRODUCTION  Spinal Schwannomas and Meningiomas are the most common intradural extramedullary lesion and account for 45% of primary Spinal Neoplasms.  The clinical futures are usually Myelopathy and/or radiculopathy  Depending on the type of tumour, different surgical techniques may be planned.

3. OBJECTIVE  To evaluate the effectiveness of MRI in differentiating intradural extramedullary spinal schwannomas and meningiomas.  To analyze tumour location, morphologic characteristics and enhancement pattern.

4. MATERIALS AND MEATHODS  Inclusion criteria:- All patients who are surgically treated and histopathologically proven as Schwannomas and meningiomas at our institution were included. Tumours with extra spinal extension such as dumbbell Schwannomas were excluded.  Exclusion criteria:- Paediatric with age less than 18 years were excluded from the study.  Study period:- Two years from February 2012 till January 2014.

5. MATERIALS AND MEATHODS Study Design:- Retrospective study. Sample Size:- 40 patients. Study Equipment:- MRI by 1.5 Tesla GE Signa HDe MRI machine. Protocol for MRI:- Axial T2 FLAIR, Axial T2 propeller, T2 sagittal T1 sequences. Data Collection:- A study was conducted on 40 patients with spinal Schwannomas and meningiomas, which were histopathologically proven after surgery.

6. MATERIALS AND MEATHODS Study Analysis:- Data Analysis was done using rates, ratios and percentages. Ethical clearance from our Institutional Ethics committee has been obtained.

7. RESULTS

8. RESULTS ANALYSIS

9. Average Age Average age is 54 years (Range 20 to 80 years)

10. MENINGIOMAS

11. TUMOUR DEVIATION

13. MENINGIOMAS

14. ISOINTENCITY on T1 WEIGHTED IMAGE

17. DEGREE OF ENHANSEMENT ON T1 WEIGHTED IMAGE

18. CONTRAST ENHANCEMENT PATTERN ON T1 IMAGE

19. CONTRAST ENHANSEMENT PATTEREN ON T1 WEIGHTED IMAGE

20. HETEROGENOUS ENHANCEMENT

21. STRONG, HOMOGENOUS & DEFFUSE EHHANCEMENT

22. ENHANCEMENT

23. DURAL TAIL SIGN

24. COMPARISION Lui WC et alDe Verdelhan et al Female sex for Meningiomas80.6 Lumbar location for Schwannomas53.3100% Thoracic location for Meningiomas80%72% Fluid signal intensity on T2- Weighted MRI for Schwannomas 55.4% Rim Enhancement for Schwannomas58.7% Dural tail sign for Meningiomas58.3%67%

25. CONCLUSION  Certain MR findings are useful for the differentiation of Schwannomas from Meningiomas of the spine.  All parameters provide statistical significance; however tumours with lumbar locations, winding of neutral foramen, fluid signal intensity on T2- weighted images, RIM enhancement on MR provide statistically significant as predictors of Schwannomas.  While tumours Located at a thoracic lesion in females and dural tail provide statistically significant predictors of Meningioma.  The differential diagnosis of spinal Schwannomas and Meningiomas on MRI can be narrowed.

26. LIMITATIONS  The limitation of the study is that it is retrospective. The reviewers are familiar with the cases of Schwannomas or Meningiomas and this may have affected the increased sensitivity setting of the MR imaging for differentiating Schwannomas from Meningiomas.  Second selection bias may have existed because of the procurement of patients through the radiology report database. Selection bias may also be a serious consideration.

27. REFERENCES  De verdelhan O, Haegelen C, Carsin – Nicol B, Riffaud L, Amlashi SF, Brassier G, Carsin M, Morandi X (2005), MR Imaging features of spinal Schwannomas and Meningiomas J. Neroradiol 32 : 42- 49.  Abul-Kasim K, Thurnher MM, Mckeever P, Sundgren PC (2008), Intraduralspinal tumours current classification and MRI futures. Nuroradiology, 50:301-314.  Gebauer GP, Farjoodi P, SciubbaDM, Gokaslan ZL, Rilley LH 3 rd, Wasserman BA, Khanna AJ (2008), Magnetic resonance imaging of spinal tumours: Classification, differential diagnosis and Spectrum of deceases. J Bone Jnt Surg Am 90: 146-162.  Schroth G, Thron A, Guhl L, Voigt K, Niendorf HP, Gr]arces LR(1987), Magnetic resonance imaging of spinal Meningiomas and neurinomas. Improving of imaging by paramagnetic contrast enhancement. J Neurosurg 66: 695-700.

28. Thank You