MR findings in all intramedullary gliomas may be similar. T1WI typically demonstrates fusiform widening of the cord over one or several segments by a soft tissue mass that is iso or slightly hypointense to normal cord. T2WI demonstrates focal areas of increased signal within the enlarged cord segments that represents the tumor and surrounding edema. There is a frequent association of both intratumoral cysts and an adjacent syrinx with astrocytomas (38%) and ependymomas (46%). It is difficult to differentiate cystic tumor from a benign or adjacent syrinx on standard spin-echo sequences, since the signal may vary depending on the fluid characteristics. Gadolinium may help in this regard, as nearly all gliomas can be expected to enhance.