Title:Distinguishing Intramedullary Spinal Cord Neoplasms from Non-Neoplastic
Conditions by Analyzing the Classic Signs on MRI in the Era of AI
Volume: 18
Author(s): Ernest Junrui Lim*, Natalie Wei Lyn Leong and Chi Long Ho
Affiliation:
- Yong Loo Lin School of Medicine, National University of Singapore, Queentown, Singapore
Keywords:
Frosting sign, intramedullary lesion, posterior vertebral scalloping , rim and flame sign, scalpel, snake-eyes sign.
Abstract: Intramedullary lesions can be challenging to diagnose, given the wide range of possible
pathologies. Each lesion has unique clinical and imaging features, which are best evaluated using
magnetic resonance imaging. Radiological imaging is unique with rich, descriptive patterns and
classic signs-which are often metaphorical. In this review, we present a collection of classic MRI
signs, ranging from neoplastic to non-neoplastic lesions, within the spinal cord. The Differential Diagnosis
(DD) of intramedullary lesions can be narrowed down by careful analysis of the classic
signs and patterns of involvement in the spinal cord. Furthermore, the signs are illustrated memorably
with emphasis on the pathophysiology, mimics, and pitfalls. Artificial Intelligence (AI) algorithms,
particularly deep learning, have made remarkable progress in image recognition tasks. The
classic signs and related illustrations can enhance a pattern recognition approach in diagnostic radiology.
Deep learning can potentially be designed to distinguish neoplastic from non-neoplastic processes
by pattern recognition of the classic MRI signs.