A Correlation Study of Imaging Patterns and Intra-operative Findings with Histopathology of Spinal Tumors at Tikur Anbessa Specialized Hospital and Zewditu Memorial Hospital, Addis Ababa University, Addis Ababa Ethiopia
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Date
2020-11
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Addis Abeba University
Abstract
Background: - Spinal cord tumors constitute 10-32% of all primary central nervous system
tumors (1, 2). Spinal tumors are classified based on their location as extradural and intradural.
Intradural tumors are classified as extra medullary and intramedullary depending on involvement
of substance of the spinal cord. There are different radiological modalities used to evaluate spinal
tumors but MRI is by far superior to all. Accurate radiologic and histopathology diagnosis is
crucial in deciding the type of management a patient should undergo and to ensure a good
prognosis. At times Intraoperative and histopathology finding of spinal lesions turn out to be
different from the type diagnosed by radiologic investigation modalities. Therefore, this study
aims to determine the correlation of imaging pattern of spinal tumors with that of intra-operative
and histopathology findings.
Objective: The purpose of this study is to assess correlation between imaging pattern and intraoperative
findings with histopathology of spinal tumors at Tikur Anbessa Hospital and Zewditu
Memorial Hospital, Addis Ababa, Ethiopia.
Methods: A facility based retrospective cross-sectional study of 47 patients was done from May
2018 to October 2020. A structured questionnaire was used to collect data for analysis.
Results: - Out of the 47 cases, intradural extra medullary tumors constituted 37 cases (78%)
followed by extradural tumors which constituted 6 cases (12.8 %) and the third being
intramedullary tumors which constituted4 cases (9.2%). Of all the cases the commonest
pathology was schwannoma 13 cases (27.7%) followed by meningioma 12 cases (25.5%).
Schwannomas were more common in males and meningioma was more common in females. Of
all the 47 cases, 27 cases (57.4%) were located in the Thoracic level followed by cervical level 9
cases (19.1%). Among 17 cases for which bone involvement was mentioned in the report, 10
cases (21.3%) showed adjacent bone involvement with the commonest change being lytic
changes seen in 4 cases (8.5%). Among 33 cases for which presence or absence of syrinx were
mentioned on the report, 28 cases (59.6%) did not have syrinx.
Out of the 47 cases, 12 cases (25.5%) did not have a definite intraoperative diagnosis, and from
the remaining cases with definite intra-operative diagnosis 21 cases (44.6 %) correlated with the
imaging diagnosis and 14 cases (29.7%) were in a disagreement. The correlation of imaging
diagnosis with that of histopathology diagnosis 61.7% were in agreement and 38.3 % were in
disagreement. From the cases that had intra-operative diagnosis, 42.6 % were in agreement and
31.9 % were in disagreement with histo-pathology diagnosis.
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Keywords
Spinal tumors,histopathology