Lengthening of theTR and TE to increase T2-weighting results in brightening of the tumor. T2-weighted images, particularly with fat suppression, provide good contrast between the hyperintense schwannoma, medium intensity paravertebral muscles, and hypointense fat. Neurofibromas and schwannomas enhance brightly and uniformly with gadolinium. Enhancement is most helpful for intradural lesions, for detection of the smaller ones and definition of the larger ones. Gadolinium is less helpful for extradural lesions because the enhancing tumor becomes isointense to the surrounding fat.
Fat suppression improves the contrast between enhancing extradural tumors and surrounding tissues.
Meningioma Meningiomas arise from the meninges surrounding the spinal cord and are found primarily in the intradural extramedullary compartment. They are much more common in females and become symptomatic from cord compression during middle age or later. Meningiomas have many of the same imaging features as nerve sheath tumors. Meningiomas also enhance rapidly and intensely, whereas neuromas take up the contrast more slowly. The presence of a broad base of attachment to a dural surface is a key feature of meningioma.