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Radiologische Diagnostik spinaler Tumoren

Teil 2: Spezielle Diagnostik intraduraler Tumoren und tumorähnlicher Läsionen

Radiological diagnostics of spinal tumors

Part 2: special diagnostics of intradural tumors and tumor-like lesions

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Zusammenfassung

Intradurale Tumoren werden nach extra- und intramedullärer Lokalisation eingeteilt. Eine eindeutige Zuordnung zu einem dieser beiden Kompartimente grenzt die Differenzialdiagnosen bereits erheblich ein. Die Magnetresonanztomographie ist die wichtigste Methode in der radiologischen Diagnostik intraduraler Tumoren. Im Gegensatz zu ossären Wirbelsäulentumoren spielen andere Modalitäten wie Projektionsradiographie und Computertomographie eine untergeordnete Rolle. Die histopathologische Klassifikation von Tumoren des zentralen Nervensystems erfolgt weltweit gemäß der WHO-Einteilung in 4 Grade. Von Grad I–IV nehmen Proliferationstendenz und Malignität zu, die Prognose korreliert invers mit dem WHO-Grad. Die Therapie spinaler intraduraler Tumoren erfolgt in der Regel neurochirurgisch. Da sich intramedulläre Tumoren allerdings neben der neurologischen Symptomatik häufig mit Fehlhaltungen der Wirbelsäule manifestieren, sind die Kenntnis der häufigsten intraduralen Tumoren und deren typische radiologische Präsentation für die orthopädische Praxis bedeutsam.

Abstract

Intradural tumors are classified into extramedullary and intramedullary localization. A distinct attribution to one of these compartments is essential for finding the appropriate diagnosis. In the radiological evaluation of intradural tumors magnetic resonance imaging (MRI) is the most important method and in contrast to osseous spinal tumors, radiography and computed tomography are of minor importance. According to the globally established WHO grading system, tumors of the central nervous system are histopathologically classified into four grades. Through grades I to IV malignancy and proliferative activity increase. Prognosis is inversely correlated to the WHO grade. Intradural tumors are generally treated by neurosurgeons. Besides neurological symptoms intradural tumors often cause spinal malpositioning. Thus knowledge of the most frequent intradural tumors and their characteristic magnetic resonance findings are important in the orthopedic practice.

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Authors and Affiliations

  1. Diagnostische und Interventionelle Radiologie, Radiologische Klinik, Universitätsklinikum Heidelberg, Heidelberg, Deutschland

    J.K. Kloth, C. Rehnitz & M.-A. Weber

  2. Abteilung für Neuroradiologie, Neurologische Universitätsklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland

    M. Wolf & S. Hähnel

  3. Department Orthopädie und Unfallchirurgie, Stiftung Orthopädische Universitätsklinik Heidelberg, Heidelberg, Deutschland

    B. Wiedenhöfer

Authors
  1. M. Wolf
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  2. J.K. Kloth
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  3. S. Hähnel
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  4. C. Rehnitz
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  5. B. Wiedenhöfer
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  6. M.-A. Weber
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Correspondence to M. Wolf.

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Wolf, M., Kloth, J., Hähnel, S. et al. Radiologische Diagnostik spinaler Tumoren. Orthopäde 41, 608–617 (2012). https://doi.org/10.1007/s00132-012-1906-y

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