Presentation
Paraparesis.
Patient Data
Small well-circumscribed intradural extramedullary mass at T9 level of left lateral location. It elicits an isosignal to the spinal cord on T1, iso-to slightly high signal on T2 and STIR with vivid homogeneous enhancement on postcontrast sequences. The adjacent segment of the spinal cord is compressed and displaced to the right with no signs of compressive myelopathy. The broad-based dural attachment is well-demonstrated on postcontrast coronal sequence. The ginkgo leaf sign is well-visualized on post contrast axial sequences.
Case Discussion
MRI features highly suggestive of spinal meningioma.
Around 80% of the spinal meningiomas are located in the thoracic region, and often of posterolateral location. The differential diagnosis should include the neurogenic tumors (spinal schwannoma and spinal neurofibroma). The ginkgo leaf sign is a useful MRI sign in distinguishing a spinal meningioma from a neurogenic tumor (e.g. spinal schwannoma).
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