 Good morning, members of faculty and delegates. I'm Dr. Simran Rajpal, third year radiology resident in Krishna Institute of Medical Sciences, Karan Maharashtra. Today my topic for discussion is intradural spinal tumors. So aims and objectives of the study include to establish role of MRI imaging in evaluation of intradural spinal lesions and to systemically classify detected intradural lesions. Materials and methods. 12 patients were included in retrospective study conducted at Department of Radiodiagnosis, Kim's Karad from August 2020 to June 2022 using Siemens 1.5 Tesla MRI machine and all patients with suspected spinal tumors were included in the study. Introduction. Intradural spinal tumors can be classified into intramedulary that is within the cord, intradural extramedulary that is within the tika but outside of the cord, intramedulary lesions. Once a lesion is determined to be within the cord substance, its location within the cord is important. Ependymomas for example are usually located centrally whereas astrocytomas are usually eccentric. Intradural extramedulary lesions, they may be related to nerve roots and may extend into furamen, example schwannomas and neurofibromas or they may have a broad dural attachment, sample meningiomas or be attached to the cord, example leptomeningal metastasis. Intradural intramedulary tumors, ependymoma. Ependymoma is the most common primary spinal cord tumor in adults and second most common in children. Most ependymomas are well circumscribed and originate from the centrally located ependymal cells and grow centrifugally with symmetric expansion of the cord. Ependymomas are iso-to-hyperintense on T1 weighted images and hyperintense on T2. About 90% of ependymomas enhance after contrast administration and show well defined margins with a homogenous pattern. Most ependymomas do not restrict on diffusion weighted images and the apparent diffusion coefficient ADC is similar or higher compared to the normal tissue. Ependymomas frequently present with hemorrhage in 20 to 60% cases easily seen on T2 star gradient eco as signal loss from blood products within the tumor or in its rostral and rostral and caudal margins which is known as the cap sign. About 60 to 90% of ependymomas have associated cysts which can be classified as tumoral or non-tumoral cysts. So here I'm presenting a case of ependymoma, the patient presented with weakness in bilateral lower limbs. So a well-defined solid cystic lesion which is iso-to-hyperintense on T1 weighted images and heterogeneously hyperintense on T2 with a hyperintense rim and on post-contrast studies the lesion shows rim enhancement and enhancement of the solid component at the cranial aspect of the lesion. The lesion is noted in the thecal sac in midline at the level of L4, L5 vertebra and does not show any expansion of the thecal sac. Imangiblastoma, it is the third most common tumor. Small imangiblastomas are iso-intense on T1, hyperintense on T2 and enhance intensively and homogenously after contrast administration. They are usually located supile in the dorsal surface of the thoracic, more common than cervical spinal cord. A disproportionality, large syringes as compared to the size of the tumor is seen in up to 64% of them. Larger imangiblastomas are hypo-intense on T1, heterogeneously hyperintense on T2 from intratumoral hemorrhage with heterogeneous hyper enhancement after contrast administration. Imangiblastomas that are larger than 2.5 centimeter have vascular flow voids on T1 and T2 arising from dilated feeding arteries and draining veins containing fast flowing arterialized blood. Assistive lesion with an enhancing neural nodule is characteristic but it is less common presentation. So presenting a case of Imangiblastoma, patient presented with pain in lower back region radiating to bilateral lower limbs. A well-defined op-long intramedular lesion is noted in conus from the level of D12 to L2 vertebra causing focal expansion which is seen on all images. The lesion shows hyperintense and hyperintense signal on T1 and T2 weighted images and heterogeneously hyperintense on flare. On humor sequence, we can see areas of blooming which is suggestive of hemorrhage and shows heterogeneous post-contrast enhancement. Astrocytoma, they are the most common intramedularis tumors in pediatric population and young adults and second most common intramedulari tumor in adults. They are more commonly located in the cervical thoracic or thoracic segments. Astrocytomas are infiltrating poorly defined neoplasm and tend to be eccentrically located with asymmetric and fusiform chord expansion. They are hyper to isointense on T1 and hyperintense on T2 and STR. Spinal astrocytoma is usually enhanced inhomigenously in a nodular or patchy manner and the enhancing tumor does not define the true tumor margins. Most astrocytomas do not restrict on DWI and their ADC values are not significantly decreased. They may have tumoral cysts with peripheral contrast enhancement as well as non-enhancing non-tumoral polar cysts and syringes. Hemorrhage is uncommon compared to appendymomas. Presenting a case of astrocytoma, patient presented with back pain and sensory disturbances. A well-defined intramedular mass lesion is noted in Dorsal's final chord from mid-part of D5 to D7 vertebral levels with chord extension and narrowing anterior subarachnoid space. The lesion appears hyper-intense on T2, heterogeneously hyper-intense with few hyper-intense areas on flare and shows heterogeneous post-contrast enhancement. Syringes is also noted along C3 to upper border of C6 vertebral levels. Extramedurally intradural tumors, meningioma. Meningiomas are the second most common intradural extramedulary neoplasm, secondary to nerve-sheet tumors. Spinal meningiomas can affect people of all ages. However, they are most prevalent between 5th and 7th decades of life. Spinal meningiomas are found with highest frequency in posterior posterior lateral or lateral thoracic, anterior cervical and lumbosacral region. The typical meningioma demonstrates iso-to-hyper intensity to the spinal cord on T1 weighted images and iso-to-slide hyper-intensity on T2 weighted acquisitions. Calcification in the mass are identified as regions of T1 and T2 weighted hyper-intensity. They show homogenous enhancement of meningioma. One may see enhancement of adjacent dura-dural tail which is commonly seen as with intracranial meningiomas but is similarly not specific for meningioma. So, this is a case of meningioma. The patient presented with right upper limb weakness since 4 months, a well-defined intradural extramedulary altered signal intensity solid region is noted on the left side at dA T9 vertebral level with broad base towards dura causing mass effect on the cord with its posterior lateral displacement towards right and widening of its lateral subarachnoid space and effacement of contralateral subarachnoid space. It appears iso intense on T1 and T2 weighted images and shows avid post-contrast enhancement. Spinal schwannomas are benign nerve-sheet tumors within the spinal canal typically arising from spinal nerve roots and it is the most common nerve-sheet tumor of spine. They most commonly involve dorsal spine nerve root. Foremenal extension is common. Schwannomas are frequently associated with hemorrhage, intrinsic vascular changes, thrombosis, sinusoidal dilatation, cyst formation and fatty degeneration. They appear as well circumscribed T1 hypo intense, T2 hyper intense mass, intense enhancement is seen but may be heterogeneous due to cystic changes in larger lesions. Heterogeneity at MRI correlates with Anthony B. Tissue. So presenting a case of schwannoma, patient presented with backache and pain in bilateral lower limbs since 2 months, a well-defined lopulated oval-shaped extramedulary intradural solid mass lesion is noted at D12-L1 levels. The lesion appears iso intense on T1, hyper intense on T2 and shows heterogeneous post-contrast enhancement with few non-enhancing central areas. The lesion is occupying central and left part of spinal canal reaching up to left neural foramina and is seen displacing and compressing the spinal cord towards right side. Neurofibromas, spinal neurofibromas are benign peripheral nerve-sheet tumors usually of the localized subtype. When located along spinal nerve roots, they are most frequently encountered along the cervical cord. Kissing paraspinal cervical and intradural tumors most commonly are associated with neurological deficits. At MRI, they show T1 iso intensity and mark T1 hyper intensity with usually intense homogenous enhancement. Plexiform neurofibroma often manifests as a large soft tissue mass with a bag of worms appearance highlighted by curveninia internal architecture. When larger masses have long-standing contact with an osteos margin such as posterior vertebral body margins, galloping from pressure erosion may be noted. Presenting a case of neurofibroma, the patient presented with bilateral lower limb weakness since past six months. A well-defined intradural lesion is noted in the conus medularis extending from upper border of D12 to L2 vertebral level. The lesion appears iso intense to chord on T1 and heterogeneously hyper intense on T2 shows heterogeneous post-contrast enhancement. The lesion is displacing the adjacent nerve root and chord towards the right side. So the result of the study out of 12 cases which were included in the study, one case was for appendymoma, one was of hemangioblastoma, one for astrocytoma, four for ninjomas, three for schwannomas and two cases were of neurofibroma. Discussion, intradural spinal neoplasms are divided into three groups based on their anatomic locations, extradural, extramedullary intradural and intramedullary tumors. Extramedullary intradural tumors include masses originating from the duras, arachnoid and nerves. The current study revealed that they are the most common spinal tumors in adults in about 20 to 30% cases and most are either many nyomas which are like 50% of cases or peripheral nerve sheet tumors which are another 50% of cases. Intramedullary spinal cord tumors occur within the spinal cord. They are the least common spinal tumor type in adults constituting only 4 to 10% cases but the most common spinal tumor in children constituting of about 35% cases. Conclusion, MRI is the preferred imaging modality for evaluating most disorders of the spine including spinal tumors. This increased sensitivity results from the fact that MRI allows for superior resolution of soft tissue structures such as intervertebral discs, spinal cords, nerve roots, meninges and paraspinal musculature. Intradural spinal tumors constitute of only 45% of all spinal melignancies. Out of all intradural spinal tumors up to 40% are extramedullary and 5% are intramedullary. So this is the algorithmic approach to spinal tumors according to anatomical location. 45% cases are of intradural tumors, 55% cases are of extradural. Out of 45% of intradural tumors, 5% of them are intramedullary which includes epindiomoma, astrocytoma, paraganglioma and 40% are extramedullary which includes meningioma, neurofibroma, schwannoma and subarachnoid metastasis and extradural tumors can be cancers of the bone or metastasis. These are the references for the paper. Thank you.