brain_tumor_-_systematic_approach脑肿瘤mr诊断

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1、BrainTumor-SystematicApproachbyRobinSmithuisandWalterMontanera河南省人民医院放射科高明译讲IntroductionIncidenceofCNStumorsAgedistributionTumorspreadIntra-versusExtraaxialMidlinecrossingMultifocaldiseaseCorticalbasedtumorsCTandMRCharacteristicsFat-Calcification-CystHighonT1LowonT2

2、DiffusionweightedimagingPerfusionImagingEnhancementDifferentialdiagnosisforspecificanatomicareaSkullbaseSella/suprasellarCerebello-pontineanglePinealregionIntraventricular4thventricleTumorMimicsSchwannomalocatedinthecerebellopontineangle(CPA)withtypicalsignsofanextr

3、aaxialtumorMeningiomawithabroadduralbaseandaduraltail，hyperostosisintheadjacentbone，enhanceshomogeneously，noblood-brain-barrierMelanomametastasiswithgraymatterontheanteromedialsideofthelesion(redarrow)，intra-axial.Ependymomawithextensiontothecerebellopontineangle(blu

4、earrow)andintotheforamenmagnum(redarrow)ortothecisternamagnaToassesstheextentofatumor.Anextra-axialtumorintheregionoftheleftcavernoussinuswithhomogeneousenhancementandabroadduraltail.Thisistypicalforameningioma.Actualextentofthistumorisgreaterthanexpected.Thetumor

5、issituatedinthepterygopalatinefossaandextendsintotheorbit.Italsospreadsanteriorlyintothemiddlecranialfossa.Considerationfortheeffectonthesurroundingstructures.Primarybraintumorsarederivedfrombraincellsandoftenhavelessmasseffectfortheirsizethanyouwouldexpect,duetothe

6、irinfiltrativegrowth.Thereisnoenhancementsothiswouldprobablybealow-gradeastrocytomaTheabilityoftumorstocrossthemidlineGlioblastomamultiforme(GBM)frequentlycrossesthemidlinebyinfiltratingthewhitemattertractsofthecorpuscallosum.RadiationnecrosiscanlooklikerecurrentGBMa

7、ndcansometimescrossthemidline.Meningiomaisanextra-axialtumorandcanspreadalongthemeningestothecontralateralside.Lymphomaisusuallylocatednearthemidline.Epidermoidcystscancrossthemidlineviathesubarachnoidspace.MScanalsopresentasamasslesioninthecorpuscallosum.Left:Metast

8、asesRight:MultiplemeningiomasandaschwannomainapatientwithNeurofibromatosisIIMultifocaldisease:MetastaticdiseaselymphomasMulticent