Radiological characterization of pediatric intramedullary astrocytomas: Do they differ from adults?

The incidence of intramedullary spinal cord tumors ranges from 2 to 4% of all central nervous system tumors. Only 6–8% are astrocytomas. The gold standard to diagnose a spinal cord tumor is the spinal cord MRI in toto. Specific radiological criteria orient the diagnosis of the intradural intramedullary lesion. Most of the authors studied adult populations of astrocytomas. However, pediatric astrocytomas present certain particularities. This work aims to determine if the usual radiological criteria of intramedullary astrocytomas (IMAs) are different depending on the patient's age. We evaluated the radiological features of IMAs in adult and pediatric groups through a retrospective study. We collected 31 patients with IMAs (11 children and 20 adults). We observed some trends but we did not highlight any statistically significant difference between all the radiological criteria studied (sagittal and axial spinal cord localization, T1-and T2-weighted characteristics, contrast uptake, infiltrating character, presence of necrosis, heterogeneous lesion, necrotic, hemorrhagic, presence of edema) and the patient's age. Given the rarity of IMAs and the lack of large specific pediatric studies, it seems essential to routinely report all cases encountered and create multicentric pediatric databases to draw more robust conclusions. •Intramedullary astrocytomas (IMA) are rare pathologies (6–8% of all spinal cord tumors).•The gold standard imaging to diagnose IMA is the spinal cord MRI.•Specific radiological criteria orient the diagnosis of IMA but most of these criteria are based on adult populations.•Some radiological criteria seem to differ between adult and pediatric populations.