[Intramedullary glioma. Postoperative MRI aspects].

MRI is the standard exploration of intramedullary tumours. Following up the patients is of prime importance to detect and treat possible recurrences at an early stage. The purpose of this paper is to specify the postoperative MRI semiology of intraspinal gliomas. During the 1986-1992 period, 47 patients operated upon in the Bicêtre hospital for primary intraspinal tumours were followed up with high-field MR (1.5 Tesla, Signa, G.E.). The retrospective visual study was carried out by two neuro-radiologists. The patients' group consisted of 24 women and 23 men aged from 15 to 67 years (mean 38 years). The tumours treated were 29 ependymomas and 18 astrocytomas. Eighty-five MRI examinations were analysed. Most of them comprised at least two planes in T1 and T2-weighted spin echo sequences with gadolinium injection, then only T1-weighted spin echo sequences after gadolinium injection (0.1 mmol/kg). The mean postoperative follow up period in the 47 patients was 32 months (range 7 to 84 months). Contrast enhancement of the spinal cord was observed in 20 cases. In the 6 patients with recurrence (5 astrocytomas, 1 malignant ependymoma) there was a segmental increase of spinal cord volume with contrast enhancement after gadolinium injection. In 3 out of these 6 patients clinical deterioration appeared later than MRI semiology. In clinically stable patients neither enhancement nor increase in spinal cord size was found in 27 cases, and enhancement alone was noted in 12 cases. There was no reliable criterion in the analysis of post gadolinium signal enhancement that could be used to differentiate recurrence from cicatricial contrast enhancement.(ABSTRACT TRUNCATED AT 250 WORDS)