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This article reviews the MRI and clinical findings in 70 spinal cord metastases; 20% of patients had multiple metastases and 8% were asymptomatic. Spinal cord metastases were the initial clinical presentation in 20% of patients. Nearly all metastases showed contrast enhancement and had extensive edema. Cysts and hemorrhage were, however, uncommon and nearly 60% of patients had other metastases to the CNS or that were seen in studies in other organs. Accompanying pial metastases were also common.

Because hemorrhagic transformation affects treatment and patient prognosis, these authors explored whether CT perfusion predicts it. Twenty percent of their subjects developed hemorrhagic transformation and these patients did not differ from controls in terms of age, gender, time to presentation, or comorbidities. Only CBV was found to be lower and predictive of hemorrhagic transformation.

These authors used phase-sensitive imaging to evaluate the presence of low-signal foci (hemorrhage or cavernoma) seen in association with developmental venous anomalies. More than 62% of patients with DVAs showed these foci, suggesting that venous congestion caused by abnormal venous drainage may be the cause and that phase-sensitive imaging is useful in their detection.