T1-weighted scans give good contrast between epidural tumor and the thecal sac. Neuroblastoma also has the potential to spread to the bone marrow. Lymphoma Another common tumor of the paravertebral region is lymphoma. It usually starts in the periaortic lymph nodes and extends from there to involve adjacent structures. Like other paraspinal tumors or infections, lymphomas have ready access to the epidural space via the neural foramina.
Osseous involvement is also possible.
MR is gaining in importance for staging of lymphomas. The early diagnosis of spinal diskitis and osteomyelitis has important clinical implications. Narrowing of the disk space also occurs in the early stages. While these signal alterations are also seen in the marrow of patients with primary or metastatic neoplastic disease, as a rule tumor does not breach the end plate. Also, although extensive involvement of the marrow cavity may be present with neoplasia, including vertebral destruction and collapse, the disk space often remains intact or is only minimally affected.