Ginkgo leaf sign (spinal meningioma)

Last revised by Francis Deng on 16 May 2020

The ginkgo leaf sign of spinal meningiomas has been described as a useful MRI sign in distinguishing a spinal meningioma from a neurogenic tumor (e.g. spinal schwannoma). 

It is seen on axial post contrast T1 imaging, with the leaf representing the distorted spinal cord, pushed to one side of the thecal sac by the meningioma, and the stem, seen as a non-enhancing 'streak', probably representing the stretched denticulate ligament 1.

Although the initial report of this sign described a 58% sensitivity 1, subsequent studies by other groups have reported a sensitivity as low as 4% 2.

See also

The ginkgo leaf sign is also used to describe the appearance of chest wall surgical emphysema (ginkgo leaf sign(chest)).

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Cases and figures

  • Figure 1: ginkgo leaf
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  • Case 1: meningioma
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