Brain Tumor - Systematic Approach脑肿瘤MR诊断英文版.ppt

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1、BrainTumor-SystematicApproachbyRobinSmithuisandWalterMontanera河南省人民医院放射科高明译讲IntroductionIncidenceofCNStumorsAgedistributionTumorspreadIntra-versusExtraaxialMidlinecrossingMultifocaldiseaseCorticalbasedtumorsCTandMRCharacteristicsFat-Calcification-CystHighonT1LowonT2DiffusionweightedimagingPerfu

2、sionImagingEnhancementDifferentialdiagnosisforspecificanatomicareaSkullbaseSella/suprasellarCerebello-pontineanglePinealregionIntraventricular4thventricleTumorMimicsSchwannomalocatedinthecerebellopontineangle(CPA)withtypicalsignsofanextraaxialtumorMeningiomawithabroadduralbaseandaduraltail，hype

3、rostosisintheadjacentbone，enhanceshomogeneously，noblood-brain-barrierMelanomametastasiswithgraymatterontheanteromedialsideofthelesion(redarrow)，intra-axial.Ependymomawithextensiontothecerebellopontineangle(bluearrow)andintotheforamenmagnum(redarrow)ortothecisternamagnaToassesstheextentofatumor.

4、Anextra-axialtumorintheregionoftheleftcavernoussinuswithhomogeneousenhancementandabroadduraltail.Thisistypicalforameningioma.Actualextentofthistumorisgreaterthanexpected.Thetumorissituatedinthepterygopalatinefossaandextendsintotheorbit.Italsospreadsanteriorlyintothemiddlecranialfossa.Consider

5、ationfortheeffectonthesurroundingstructures.Primarybraintumorsarederivedfrombraincellsandoftenhavelessmasseffectfortheirsizethanyouwouldexpect,duetotheirinfiltrativegrowth.Thereisnoenhancementsothiswouldprobablybealow-gradeastrocytomaTheabilityoftumorstocrossthemidlineGlioblastomamultiforme(GBM)

6、frequentlycrossesthemidlinebyinfiltratingthewhitemattertractsofthecorpuscallosum.RadiationnecrosiscanlooklikerecurrentGBMandcansometimescrossthemidline.Meningiomaisanextra-axialtumorandcanspreadalongthemeningestothecontralateralside.Lymphomaisusuallylocatednearthemidline.Epidermoidcystscancrosst

7、hemidlineviathesubarachnoidspace.MScanalsopresentasamasslesioninthecorpuscallosum.Left:MetastasesRight:MultiplemeningiomasandaschwannomainapatientwithNeurofibromatosisIIMultifocaldisease:MetastaticdiseaselymphomasMulticent