Ginkgo leaf sign: a highly predictive imaging feature of spinal meningioma

Satoshi Yamaguchi; Masaaki Takeda; Toshiyuki Takahashi; Hitoshi Yamahata; Takafumi Mitsuhara; Tadaaki Niiro; Junya Hanakita; Kazutoshi Hida; Kazunori Arita; Kaoru Kurisu

doi:10.3171/2015.3.SPINE1598

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Ginkgo leaf sign: a highly predictive imaging feature of spinal meningioma

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Ginkgo leaf sign: a highly predictive imaging feature of spinal meningioma

Satoshi Yamaguchi, Masaaki Takeda, Toshiyuki Takahashi, Hitoshi Yamahata, Takafumi Mitsuhara, Tadaaki Niiro, Junya Hanakita, Kazutoshi Hida, Kazunori Arita and Kaoru Kurisu

Journal of neurosurgery. Spine, Vol.23(5), pp.642-646

11/2015

DOI: 10.3171/2015.3.SPINE1598

PMID: 26230423

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Abstract

OBJECT Spinal meningioma and schwannoma are the most common spinal intradural extramedullary tumors, and the differentiation of these 2 tumors by CT and MRI has been a matter of debate. The purpose of this article is to present a case series of spinal meningiomas showing unique imaging features: a combination of a fan-shaped spinal cord and a streak in the tumor. The authors termed the former imaging feature “ginkgo leaf sign” and evaluated its diagnostic value. METHODS The authors present 7 cases of spinal meningioma having the ginkgo leaf sign. Thirty spinal extramedullary tumors arising lateral or ventrolateral to the spinal cord were studied to evaluate the diagnostic value of the ginkgo leaf sign for spinal meningiomas. Among 30 cases, 12 tumors were spinal meningiomas and 18 tumors from the control group were all schwannomas. RESULTS Seven of the 12 spinal meningiomas were positive for the ginkgo leaf sign. The sign was not present in the control group tumors. The overall ability to use the ginkgo leaf sign to detect meningioma indicated a sensitivity of 58%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 78%. CONCLUSIONS The ginkgo leaf sign is highly specific to spinal meningiomas arising lateral or ventrolateral to the spinal cord. In the present series, the ginkgo leaf sign was perfectly predictive for spinal meningioma.

Details

Title: Subtitle: Ginkgo leaf sign: a highly predictive imaging feature of spinal meningioma
Creators: Satoshi Yamaguchi - 1Department of Neurosurgery, Hiroshima University, Graduate School of Biomedical and Health Sciences, Hiroshima
Masaaki Takeda - 1Department of Neurosurgery, Hiroshima University, Graduate School of Biomedical and Health Sciences, Hiroshima
Toshiyuki Takahashi - 2Fujieda Heisei Memorial Hospital, Fujieda, Shizuoka
Hitoshi Yamahata - 3Department of Neurosurgery, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima; and
Takafumi Mitsuhara - 1Department of Neurosurgery, Hiroshima University, Graduate School of Biomedical and Health Sciences, Hiroshima
Tadaaki Niiro - 3Department of Neurosurgery, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima; and
Junya Hanakita - 2Fujieda Heisei Memorial Hospital, Fujieda, Shizuoka
Kazutoshi Hida - 4Sapporo Azabu Neurosurgical Hospital, Sapporo, Hokkaido, Japan
Kazunori Arita - 3Department of Neurosurgery, Kagoshima University, Graduate School of Medical and Dental Sciences, Kagoshima; and
Kaoru Kurisu - 1Department of Neurosurgery, Hiroshima University, Graduate School of Biomedical and Health Sciences, Hiroshima
Resource Type: Journal article
Publication Details: Journal of neurosurgery. Spine, Vol.23(5), pp.642-646
DOI: 10.3171/2015.3.SPINE1598
PMID: 26230423
NLM abbreviation: J Neurosurg Spine
ISSN: 1547-5654
eISSN: 1547-5646
Publisher: American Association of Neurological Surgeons
Language: English
Date published: 11/2015
Academic Unit: Neurosurgery
Record Identifier: 9984040548102771

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