Ependymoma MRI: Difference between revisions
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Ependymoma-lateral-ventricle(9).jpg|DWI<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref> | Ependymoma-lateral-ventricle(9).jpg|DWI<ref name=radio> Image courtesy of Dr Frank Gaillard. [http://www.radiopaedia.org Radiopaedia](original file [http://radiopaedia.org/cases/ependymoma-lateral-ventricle ‘’here’’]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC]</ref> | ||
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<sup>''Note'':There is a large left frontal mixed cystic/solid lesion, measuring approximately 4x4x5cm in perpendicular dimensions, with intralesional haemorrhage and fluid level which may indicate areas of necrosis. Large surrounding vasogenic edema involving the contralateral hemisphere, and significant mass effect causing almost 2cm midline shift, obstructing the monro foramina resulting moderate non-communicating hydrocephalus.</sup> | <sup>''Note'':There is a large left frontal mixed cystic/solid lesion, measuring approximately 4x4x5cm in perpendicular dimensions, with intralesional haemorrhage and fluid level which may indicate areas of necrosis. Large surrounding vasogenic edema involving the contralateral hemisphere, and significant mass effect causing almost 2cm midline shift, obstructing the monro foramina resulting moderate non-communicating hydrocephalus.</sup> | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 18:40, 7 October 2015
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Ependymoma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Ependymoma MRI On the Web |
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American Roentgen Ray Society Images of Ependymoma MRI |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Imaging plays a central role in the diagnosis of ependymoma. On MRI brain, ependymoma is characterized by isointense to hypointense on T1-weighted scans, or hyperintense to white matter on T2-weighted MRI.
MRI
Brain
- T1
- Solid portions of ependymoma typically are isointense to hypointense relative to white matter 7
- T2
- Hyperintense to white matter
- More reliable in differentiating tumour margins than non-contrast T1-weighted images (but less reliable than contrast enhanced T1)
- T2* (e.g. SWI)
- Foci of blooming from haemorrhage or calcification
- T1 C+ (Gd)
- Enhancement present but heterogeneous
- Enhancement with gadolinium is useful in differentiating tumour from adjacent vasogenic oedema and normal brain parenchyma
- DWI/ADC
- Restricted diffusion may be seen in solid components especially in anaplastic tumour
- Diffusion should be interpreted with caution in masses with significant haemorrhage or calcification
- MRS
- Choline peak elevation according to the cellularity of tumor
- N-Acetylaspartate peak reduction
- Elevated choline/creatinine ratio
- Lipid and lactate rise when degeneration occurs
![T1[1]](/index.php/File:A91344c612b07b087964a93ee047df_big_gallery.jpg)
![T2[1]](/index.php/File:73c54460c3e8d80f3d18cd522ed152_big_gallery.jpg)
![FLAIR[1]](/index.php/File:Ependymoma-lateral-ventricle(5).jpg)
![T1[1]](/index.php/File:Ependymoma-lateral-ventricle(7).jpg)
![T1+C[1]](/index.php/File:Ependymoma-lateral-ventricle(97777).jpg)
![DWI[1]](/index.php/File:Ependymoma-lateral-ventricle(9).jpg)
Note:There is a large left frontal mixed cystic/solid lesion, measuring approximately 4x4x5cm in perpendicular dimensions, with intralesional haemorrhage and fluid level which may indicate areas of necrosis. Large surrounding vasogenic edema involving the contralateral hemisphere, and significant mass effect causing almost 2cm midline shift, obstructing the monro foramina resulting moderate non-communicating hydrocephalus.
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Image courtesy of Dr Frank Gaillard. Radiopaedia(original file ‘’here’’).Creative Commons BY-SA-NC