Diagnostic Accuracy of Magnetic Resonance Imaging in Intramedullary Spinal Cord Tumors: Correlation with Histopathological Diagnosis

Open Access

Abstract

Background: Intramedullary spinal cord tumors are uncommon lesions that may cause progressive neurological impairment. Magnetic resonance imaging (MRI) is central to their preoperative evaluation, but histopathological examination remains essential for definitive diagnosis. This study assessed the diagnostic accuracy of MRI in intramedullary spinal cord tumors using histopathology as the reference standard. Methods & Materials: This observational cross-sectional study included 32 patients with clinically suspected intramedullary spinal cord masses who underwent MRI followed by surgical intervention and histopathological evaluation. MRI examinations were performed using T1-weighted, T2-weighted, FLAIR and post-gadolinium T1-weighted sequences. MRI diagnoses were compared with histopathological findings. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Results: The mean age was 36.75 ± 13.41 years, with most patients aged 21-40 years (53.1%). MRI identified ependymoma in 17 (53.1%), astrocytoma in 13 (40.6%) and hemangioblastoma in 2 (6.3%) patients. Histopathology confirmed ependymoma in 15 (46.9%), astrocytoma in 13 (40.6%), hemangioblastoma in 2 (6.3%), metastasis in 1 (3.1%) and schwannoma in 1 (3.1%). MRI showed sensitivity, specificity and accuracy of 93.3%, 82.3% and 87.5% for ependymoma and 92.3%, 94.7% and 93.8% for astrocytoma, respectively. Hemangioblastoma showed 100% for all validity measures. Conclusion: MRI demonstrated high diagnostic accuracy for the common intramedullary spinal cord tumors, particularly ependymoma and astrocytoma. Histopathological examination remains essential for definitive diagnosis, especially for uncommon lesions.