Table 3 Suggested MRI and CT structured report for paraspinal lesions
From: Understanding a mass in the paraspinal region: an anatomical approach
MRI reporting |
|---|
Size |
Location  Epicentre: Epaxial/hypaxial  Segmental longitudinal extension |
Matrix  Fat content (high signal on both T1 and T2WI)  Myxoid content (fluid-like signal intensity; enhancement)  Fibrous content (low signal on both T1 and T2WI)  Haemorrhagic content (signal change with evolving breakdown products; Blooming artefact of T2WI)  Necrotic or cystic |
Bone involvement (vertebra, rib)  Suggestive signs of reactive inflammatory changes or vertebral invasion: cortical abutment and disappearance of paravertebral fat on T1WI, enhancement on T1WI fat-suppressed, periosteal signal change,  Bone tumour invasion: low signal on both fat-suppressed T2WI and T1WI, scalloping  when present, details the tumour extension within the different parts of the bone |
Relationship with spinal nerve and intervertebral foramen  Fat plane (high intensity on T1WI) separating the neurovascular pedicle and the tumour  Extension into the intervertebral foramen  Foramen enlargement |
Locoregional invasion of adjacent compartments or organs  Pleura  Posterior mediastinum  Retroperitoneum  Epidural space  Skip metastasis |
Scanner reporting |
|---|
Tumour size, location, matrix |
Bone involvement (vertebra, rib)  Suggestive of a tumour process: bone lysis (geographics, sclerotic, permeative)  Suggestive of mimics: erosions, calcifications, osteodystrophy  Foramen enlargement |
Distant extension—invasion of others compartments or organs  Multiple lesions  Invasion to adjacent compartments or organs  Lymph nodes status  Distant metastatic disease (for malignant and metastasising tumours) |