Differential Diagnosis of Ossified Spinal Meningiomas from Psammomatous Spinal Meningiomas Based on CT and MRI and Surgical Strategy

Introduction: Ossified spinal meningiomas (OSMs) and psammomatous spinal meningiomas (PSMs) each exhibit distinct histological features. Surgical approaches also differ between the two types. Preoperative differentiation between OSMs and PSMs aids in treatment planning. This study aims to distinguish OSMs from PSMs through imaging. Methods Differences between OSMs and PSMs were compared using computed tomography (CT) and magnetic resonance imaging (MRI). The key points of surgery for OSMs were also summarized. Results On the basis of the pathological findings, the patients were divided into OSM and PSM groups. Imaging analysis revealed that the CT signal ratio (2.45) was significantly greater in the OSM group than in the PSM group (0.65), while the T1, T2, and T1 contrast-enhanced signal ratios (0.79, 0.71, and 1.42, respectively) were significantly lower in the OSM group than in the PSM group (1.09, 1.54, and 1.95, respectively; all p values < 0.001). All patients underwent complete tumor resection. Most patients experienced symptomatic improvement after surgery, and no tumor recurrence was observed during follow-up. Conclusion The imaging features differ between OSMs and PSMs. Through specialized surgical approaches and intraoperative neurophysiological monitoring, tumors located on the ventral aspect of the spinal cord can be safely and completely resected.