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AJNR - American Journal of Neuroradiology

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Alcohol Ablation of SymptomaticVertebral Hemangiomas

Mayank Goyal^a, Nalin K. Mishra^a, Aseem Sharma^a, Shailesh B. Gaikwad^a, B. K. Mohanty^a and Sanjiv Sharma^a

^a From the Department of Neuroradiology (M.G., N.K.M., A.S., S.B.G.), Cardiac-radiology (S.S.), and Radiation Oncology (B.K.M.), All India Institute of Medical Sciences, New Delhi 110 029 India.

View larger version (101K): [in a new window]   FIG 1. Axial CT scan at the level of the maximal epidural soft-tissue component of the hemangioma taken during injection of contrast medium through the needle positioned into the vertebral body. Note the excellent opacification of the epidural soft tissue on either side of midline (arrow)

View larger version (86K): [in a new window]   FIG 2. Axial CT scan obtained similarly in another patient shows extravasation of contrast into the paraspinal muscles (arrow) and pleural cavity. The procedure was abandoned at this stage

View larger version (132K): [in a new window]   FIG 3. A 35-year old man who presented with paraparesis. T1- (A) (450/15/3, [TR/TE/excitations]) and T2-weighted (B) (4200/90/1) sagittal MR images show a typical hemangioma at middorsal level. The posterior elements also are involved, and the spinal canal is compromised. Note the presence of hyperintense signal within the spinal cord on the T2-weighted image

View larger version (127K): [in a new window]   FIG 4. Sequential MR images of a 35-year old woman with SVH who underwent an uneventful alcohol ablation of the lesion. Preprocedural T1-weighted (A) (500/15/3) and T2-weighted (B) (3800/91/1) axial images at the level of the lesion show the hemangioma with a large epidural soft-tissue component causing compression of the spinal cord. Follow-up T1-weighted (C) (540/18/3) and T2-weighted images (D) (3800/91/1) after an interval of 2 months show a dramatic reduction of soft-tissue hemangiomatous involvement. Note the change in signal in the vertebral-body hemangioma on the follow-up MR images (C and D)