Evidence map›Paper›PMID 32382876›Full record

ArticleClinical neuroradiology2021

The Central Dot Sign : A Specific Post-gadolinium Enhancement Feature of Intramedullary Spinal Cord Metastases.

Ajay A Madhavan, Felix E Diehn, Jeffrey B Rykken, John T Wald, Chris P Wood, Kara M Schwartz, Timothy J Kaufmann, Christopher H Hunt, Dong Kun Kim, Laurence J Eckel

Abstract read
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In one paragraph

Article in Clinical neuroradiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ajay A MadhavanDivision of Neuroradiology, Department of Radiology, Mayo Clinic, 200 First St SW, MN 55905, Rochester, USA. madhavan.ajay@mayo.edu.
Felix E DiehnDivision of Neuroradiology, Department of Radiology, Mayo Clinic, 200 First St SW, MN 55905, Rochester, USA.
Jeffrey B RykkenDivision of Neuroradiology, Department of Radiology, University of Minnesota, 420 Delaware St SE, MN 55455, Minneapolis, USA.
John T WaldDivision of Neuroradiology, Department of Radiology, Mayo Clinic, 200 First St SW, MN 55905, Rochester, USA.
Chris P WoodDivision of Neuroradiology, Department of Radiology, Mayo Clinic, 200 First St SW, MN 55905, Rochester, USA.
Kara M SchwartzDivision of Neuroradiology, Department of Radiology, Mayo Clinic, 200 First St SW, MN 55905, Rochester, USA.
Timothy J KaufmannDivision of Neuroradiology, Department of Radiology, Mayo Clinic, 200 First St SW, MN 55905, Rochester, USA.
Christopher H HuntDivision of Neuroradiology, Department of Radiology, Mayo Clinic, 200 First St SW, MN 55905, Rochester, USA.
Dong Kun KimDivision of Neuroradiology, Department of Radiology, Mayo Clinic, 200 First St SW, MN 55905, Rochester, USA.
Laurence J EckelDivision of Neuroradiology, Department of Radiology, Mayo Clinic, 200 First St SW, MN 55905, Rochester, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePeripheral enhancement characteristics on magnetic resonance imaging (MRI), namely the rim and flame signs, are specific for intramedullary spinal cord metastases (ISCM) compared to primary cord masses. The study compared the frequency of a novel finding-the central dot sign-in ISCMs versus primary intramedullary masses.

methodsIn this study 45 patients with 64 ISCMs and 64 control patients with 64 primary intramedullary cord masses were investigated and 2 radiologists blinded to lesion type independently evaluated MR images for the presence of a central dot sign: a punctate focus of enhancement in/near the center of an enhancing intramedullary mass. The frequency of this sign in the two patient groups was compared.

resultsA total of 63 enhancing ISCMs in 44 patients and 54 enhancing primary cord masses in 54 patients were included. The central dot sign was identified in 6% (4/63) of enhancing ISCMs in 9% (4/44) of patients and in none (0/54) of the enhancing primary cord masses (p = 0.038, per patient). The specificity for diagnosing ISCMs among spinal cord masses was 100%. The central dot sign was present in the axial plane only in two ISCMs and in the axial and sagittal planes in two ISCMs. The two ISCMs harboring the central dot sign also demonstrated both the previously described rim and flame signs, and two also demonstrated the rim sign alone.

conclusionThe central dot sign is not sensitive but highly specific for ISCMs compared to primary spinal cord masses. The rim and/or flame signs may or may not be concurrently present in ISCMs.

Indexed as

Spinal Cord NeoplasmsContrast MediaGadoliniumHumansMagnetic Resonance ImagingSpinal CordContrast MediaGadoliniumFlame signIntramedullary enhancementIntramedullary lesionRim signSpinal cord lesion

Identifiers

PMID32382876

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.